title: Successful free osteocutaneous scapular flap transfer for mandibular reconstruction in a 93-year-old patient.
abstract: With the extension of the average life span and the development of surgical technique, anesthesia, and pre- and postoperative management, operations for elderly patients have become more widely accepted. In the field of plastic surgery, free-flap transfers using microvascular techniques have become a common surgical procedure in reconstruction of the head and neck region after surgical removal of a cancer. There have been several reports of free-flap transfer in patients older than 90 years, but the authors know of no reports of free osteocutaneous flap transfer for mandibular reconstruction, which is a very invasive free-flap surgery, for such patients. The mandible plays a significant role in various kinds of dynamic functions, such as mastication, deglutition, and articulation. Disorder of these functions causes a deterioration in the patient's quality of life. The authors have performed a mandibular reconstruction using an osteocutaneous scapular free flap after resection of a gingival cancer invading the mandibular bone in a 93-year-old Japanese woman. In our case, an osteocutaneous scapular free flap, which permits the patient rapid rehabilitation of the lower leg, is thought to be a good choice because it allows the patient to get out of bed as quickly as possible in the postoperative period to minimize additional complications.
authors.affiliation: Division of Plastic Surgery, Nara Medical University, Kashihara, Japan. niitsuma@nmu-gw.naramed-u.ac.jp
authors.forename: Katsunori
authors.initials: K
authors.lastname: Niitsuma
authors.forename: Mitsuo
authors.initials: M
authors.lastname: Hatoko
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Kuwahara
authors.forename: Aya
authors.initials: A
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Iioka
authors.forename: Takehiko
authors.initials: T
authors.lastname: Fukuda
authors.forename: Katsunari
authors.initials: K
authors.lastname: Yane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D005260:Female; D005887:Gingival Neoplasms / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000534:rehabilitation / Q000601:surgery; D008833:Microcirculation; D019647:Oral Surgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D012540:Scapula / Q000601:surgery; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps