J Korean Assoc Maxillofac Plast Reconstr Surg.  2004 Jan;26(1):103-109.

Reconstruction using fibular osteocutaneous free flap of squamous cell carcinoma occurred in mandibular alveolar ridge accompanied with osteoradionecrosis

• Kim UK
• Kim YD
• Byun JH
• Shin SH
• Chung IK

Abstract

Radiation therapy and surgery are established treatments for malignancies in the head and neck region. For most early-stage head and neck cancers, radiation therapy and surgery are equally effective. Except for recurrent malignancy, one of the worst clinical scenarios of the radiation therapy is the development of osteoradionecrosis. Osteoradionecrosis is a chronic side effect of radiotherapy which progresses slowly and dose not tend to heal spontaneously. Its most common location is the mandible, most likely due to the relatively poor vascularization of the lower jaw. Although some cases may respond to local therapy with or without hyperbaric oxygen, most clinically significant cases will require reconstruction by either a musculocutaneous flap or a microvascular free flap since surrounding affected tissues must be resected as well. A variety of free flap donor sites have been used successfully for mandibular reconstruction. The fibular free flap is rapidly becoming the most popular choice for reconstruction of oromandibular defects after tumor resection or osteoradionecrosis. Up to 25cm of fibula bone can be harvested in the adult male, and the fibular's rich periosteal blood supply allows the creation of multiple osteotomies for precise contouring of the neomandible without compromising the bone's viability. We report a case of reconstruction using fibular osteocutaneous free flap of squamous cell carcinoma occurred in mandibular alveolar ridge accompanied with osteoradionecrosis.

Keyword

Osteoradionecrosis; Fibular osteocutaneous free flap

MeSH Terms

Adult
Alveolar Process*
Carcinoma, Squamous Cell*
Fibula
Free Tissue Flaps*
Head
Humans
Jaw
Male
Mandible
Mandibular Reconstruction
Myocutaneous Flap
Neck
Osteoradionecrosis*
Osteotomy
Oxygen
Radiotherapy
Tissue Donors
Oxygen