Comparison of reconstructive procedures in primary versus secondary mandibular reconstruction.
BACKGROUND
Few reports have compared reconstructive outcomes of primary versus secondary mandibular reconstruction.


METHODS
A retrospective chart review was performed on 149 patients following primary (n = 110) and secondary reconstruction (n = 39).


RESULTS
There was no statistically significant difference in patient demographics between the 2 groups. The secondary reconstruction mandibular defects were more extensive; significantly more involved the condyle or the central portion of the mandible. The vascularized fibular flap was most commonly used (primary 82%, secondary 69%). The overall complication rate was similar in both groups. There was no statistical difference in the frequency of complications between the primary or secondary reconstruction groups (acute, p = .40; late, p = .17).


CONCLUSIONS
Success in secondary mandibular reconstruction could be achieved utilizing a range of osseous free flaps, and there was no increased rate of complications compared with primary mandibular reconstructions.
Andrade
William N
WN
Department of Surgery, University of Toronto, Toronto, Ontario, Canada.
Lipa
Joan E
JE
Novak
Christine B
CB
Grover
Harpreet
H
Bang
Christian
C
Gilbert
Ralph W
RW
Neligan
Peter C
PC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005360:Fibula / Q000637:transplantation; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008338:Mandibular Injuries / Q000601:surgery; D008339:Mandibular Neoplasms / Q000601:surgery; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010019:Osteomyelitis / Q000601:surgery; D010025:Osteoradionecrosis / Q000601:surgery; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply; D016896:Treatment Outcome