Factors influencing the long-term outcome of mandibular reconstruction.
OBJECTIVE
The aim of this study was to understand the association of 30 candidate variables with the outcome of mandibular reconstruction.


METHODS
Seventy cases of mandibular reconstruction performed between 1976 and 1991 were identified. Medical records were reviewed for all patients. Thirty variables, including patient factors, preoperative preparation, and intraoperative and postoperative findings were determined for each patient. Bone graft outcome was evaluated in 2 ways: 1) Fisher's exact tests and logistic regression models were used to determine the association between the clinical parameters and the success of the bone graft at 1 year and 2) proportional hazard regression models were then used to identify the predictors of bone graft survival time from the 30 chosen variables.


RESULTS
Multivariate analysis determined that greater blood loss during the procedure (P = .018) and the presence of postoperative recipient site complications (P = .010) were significantly associated with bone graft failure during the first year. The diagnosis of malignant disease (P = .006), the use of sternocleidomastoid muscle (SCM) flaps for soft tissue augmentation (P < .001), longer duration of suction drainage (P = .001), and the presence of postoperative recipient site complications (P = .013) were found to be significant predictors of graft survival time in the proportional hazard regression model.


CONCLUSIONS
The analysis of parameters associated with bone graft outcome may aid in surgical decision making and help improve the likelihood of a successful result in the future.
August
M
M
Department of Oral and Maxillofacial Surgery and the Medical Practices Evaluation Center, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston 02114, USA. maugust@partners.org
Tompach
P
P
Chang
Y
Y
Kaban
L
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000706:statistics & numerical data; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome