Mandibular osteoradionecrosis: reconstructive surgery.
Osteoradionecrosis of the mandible is a serious complication following radiotherapy of head and neck cancers. A retrospective study of 20 reconstructions of mandibular defects due to osteoradionecrosis was performed. Various osseocutaneous free flaps were used: upper lateral arm (n = 5), radial forearm (n = 1), iliac crest (n = 4) and fibula (n = 7). Four grafts had a condylar prosthesis, and for seven grafts fixation was accomplished with a reconstruction plate. In three patients the mandibular defect was reconstructed using a bridging plate only. We defined a successful reconstruction as a graft or plate that did not need removal. Success was noted in 15 out of 20 patients, giving an overall success rate of 75%. For the free grafts alone (n = 17), successful reconstruction was achieved in 15 patients (88%). Two fibular grafts were lost owing to exposure and infection, as well as all three alloplastic reconstructions. Minor postoperative complications were observed in 11 patients (58%).
Støre
G
G
Department of Otolaryngology, Rikshospitalet University Hospital, Oslo, Norway.
Boysen
M
M
Skjelbred
P
P
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D019248:Jaw Fixation Techniques; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery*; D008866:Microsurgery; D008875:Middle Aged; D010025:Osteoradionecrosis / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures