Maxillofac Plast Reconstr Surg.  2015 Feb;37(2):7. 10.1186/s40902-015-0007-3.

Reconstruction with fibular osteocutaneous free flap in patients with mandibular osteoradionecrosis

• Kim MG
• Lee ST
• Park JY
• Choi SW

• KMID: 2381879
• DOI: http://doi.org/10.1186/s40902-015-0007-3

Abstract

BACKGROUND
Osteoradionecrosis is a delayed complication from radiation therapy which causes chronic pain, infection and constant deformity after necrosis. Most of the osteoradionecrosis occurs spontaneously or after the primary oncologic surgery, dental extraction or by trauma of prosthesis. The treatment of osteoradionecrosis relies on both conservative measures and surgical measures. The fibular osteocutaneous free flap has become more popular choice for reconstruction of maxillofacial defects as a treatment of osteoradionecrosis.
METHODS
We presented our experiences from 7 patients with osteoradionecrosis who have had reconstruction surgery with fibular osteocutaneous free flap at National Cancer Center during the recent 5 years. We performed segmental mandibular resection with fibular osteocutaneous free flap for all 7 patients of advanced osteoradionecrosis who were not controlled by conservative treatment such as wound irrigation, debridement, and antibiotics.
RESULTS
A wide range of techniques were available for the reconstruction of composite defects resulted from the treatment of advanced mandibular osteoradionecrosis. Significant improvement was noted in relieving pain and treating trismus after the surgery however difficulty in swallowing and xerostomia showed less improvement.
CONCLUSIONS
We concluded that fibular osteocutaneous free flap can be performed safely in patients with osteoradionecrosis and yields positive outcomes with significantly increased success rate. The fibular osteocutaneous free flap was our preferred choice for the mandibular reconstruction due to its versatility and predictability.

Keyword

Osteoradionecrosis; Mandible; Fibular; Radiation; Free flap

MeSH Terms

Anti-Bacterial Agents
Chronic Pain
Congenital Abnormalities
Debridement
Deglutition
Free Tissue Flaps*
Humans
Mandible
Mandibular Reconstruction
Necrosis
Osteoradionecrosis*
Prostheses and Implants
Trismus
Wounds and Injuries
Xerostomia
Anti-Bacterial Agents