Free Flap Reconstruction of Osteoradionecrosis of the Mandible: a 10-year Review and Defect Classification

Overview

Journal Head Neck

Specialties General Surgery
Oncology

Date 2011 May 12

PMID 21560178

Citations 19

Authors

Donald P Baumann

Peirong Yu

Matthew M Hanasono

Roman J Skoracki

Affiliations

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Abstract

Background: The purpose of this study was to evaluate outcomes of free flap reconstruction for advanced osteoradionecrosis (ORN) defects and develop an algorithm to guide surgical planning.

Methods: All cases involving free flap reconstruction for ORN of the mandible between 1998 and 2008 were reviewed. A defect classification scheme was developed. Flap selection and outcomes were analyzed and evaluated by defect type.

Results: Seventy-five free flaps and 13 pedicle flaps were performed in 63 patients. Total flap loss was 5%. Overall surgical complication was 32%. Complication rates were higher with bone flaps than with soft tissue flaps (p = .018). A full oral diet was tolerated in 57% of patients, whereas 26% required partial tube feeding, and 16% were tube-feeding dependent.

Conclusion: Free flap reconstruction of advanced ORN defects can be safely performed in a variety of flap configurations with good outcomes. The classification scheme may assist in flap selection.

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Watson E, Hueniken K, Lee J, Huang S, El Maghrabi A, Xu W J Clin Oncol. 2024; 42(16):1922-1933.

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