[Vascularized osseous flaps for mandibular reconstruction after osteoradionecrosis].
BACKGROUND
The reconstruction of mandibular continuity destroyed by osteoradionecrosis can be a difficult task. The aim of this study was to evaluate the reliability and contribution of vascular osseous flaps for mandibular reconstruction after osteoradionecrosis.


METHODS
A retrospective study of patients undergoing mandibular reconstruction after osteoradionecrosis between 1989 and 2002 was performed. Twenty-five mandibular reconstructions were performed in 23 patients: 16 fibular free flaps, 5 osteomuscular serrato-costal free flaps, 1 osteocutaneous external brachial free flap, 1 medial femoral condylar free flap and 2 armed pectoralis major pediculed flaps.


RESULTS
We observed two major complications (8%): loss of one fibular flap and one medial femoral condylar free flap. We observed 42% minor complications. Overall quality of life was constantly enhanced.


CONCLUSIONS
Fibular flap is definitely a good method for immediate or secondary mandibular reconstruction. A serratocostal flap must be considered as an alternative flap when the fibular flap is unavailable.
Girod
A
A
Service de Chirurgie maxillo-faciale, stomatologie et plastique de la face, CH Lyon-Sud, Pierre-Benite.
Boulétreau
P
P
Freidel
M
M
Breton
P
P
D000328:Adult; D000368:Aged; D016025:Bone Transplantation / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D005260:Female; D006085:Graft Survival; D006801:Humans; D008297:Male; D008336:Mandibular Diseases / Q000601:surgery*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000532:radiotherapy; D018482:Muscle, Skeletal / Q000637:transplantation; D010025:Osteoradionecrosis / Q000601:surgery*; D010369:Pectoralis Muscles / Q000637:transplantation; D011183:Postoperative Complications; D011788:Quality of Life; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D015203:Reproducibility of Results; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps