Efficacy and safety of reconstruction of mandibular defect in 40 patients with osteoradionecrosis of the jaw with free fibular osteomyofascial compound flap

doi:10.19438/j.cjoms.2018.03.016

Abstract

Abstract: PURPOSE: To explore the clinical efficacy of free fibular osteomyofascial compound flap in mandibular defect reconstruction in patients with osteoradionecrosis of the jaws (ORNJ). METHODS: From March 2014 to July 2017, 40 patients with mandibular ORNJ undergoing oral and maxillofacial surgery at Sun Yat-sen Memorial Hospital of Sun Yat-sen University were enrolled. All patients had primary nasopharyngeal carcinoma, excluding recurrent nasopharyngeal carcinoma. Free peroneal dermis fascia composite flap was used to reconstruct bone defects after surgical resection of the radiated mandibular necrosis. The skin and soft tissue defects were repaired with skin island. Fascia was used for mucosal defect repair to fill the soft tissue defects. The fibular osteotomy and tissue flap survival, donor, complications, postoperative mouth opening and occlusion of remaining teeth were evaluated for reconstruction outcomes. RESULTS: After 3 to 6 months of follow-up, free fibular peroneal fascial composite flap was successfully used to reconstruct mandibular defects. Mandibular osteotomy was 5.5-16.0 cm in length, and the harvested fibula was 7.5-17.0 cm in length. No patient had serious donor or recipient site complications. All patients had satisfactory facial shape, remaining normal occlusion, and mouth opening was 1.0-3.5 cm. CONCLUSIONS: Free fibular peroneal fascia composite flap can reconstruct maxillofacial soft and hard tissue defects after radio in patients with ORNJ and reduce complications, which is worthy of clinical application.

Key words: Mandible, Osteoradionecrosis, Fibular osteomyofascial compound flap

CLC Number:

R782.2

LIU Jun-ping, LI Qun-xing, ZHANG Han-qing, OU Zhan-peng, FAN Song, LI Jin-song.. Efficacy and safety of reconstruction of mandibular defect in 40 patients with osteoradionecrosis of the jaw with free fibular osteomyofascial compound flap[J]. China Journal of Oral and Maxillofacial Surgery, 2018, 16(3): 270-274.

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