[Fibular free-flap for mandibular reconstruction in patients undergoing mandibulectomy for oral cavity and bone tumors: 10-year experience].
BACKGROUND
Fibular-free-flap is currently considered the optimum choice in mandible reconstruction.


OBJECTIVE
Assess our results using this technique after 10 years-experience.


METHODS
Patients underwent mandibulectomy and primary or secondary reconstruction with fibular-free-flap between 1995 and 2005. Variables analyzed included: surgical time, time of micro-vascular anastomosis, bleeding, tobacco history, comorbidity, chemo-radiotherapy background, flap type and primary or secondary reconstruction.


RESULTS
We included, 60 patients and performed 62 flaps. We included 27 women and 33 men; mean age was 43 years, 30 had malignant tumors and 30 benign. Diabetes was the most frequent co-morbid pathology. In 49 subjects reconstruction was primary and secondary in 11; in 38 the flap was osseous and in 22 osteocutaneous. In 52 patients (87%) the flap was successful and 8 showed total loss. The most frequent complications were osteosynthesis material exposure, pseudoarthrosis and cervical abscess. Four patients were subjected to re-exploration but the flap was preserved in all. No acssociation was found among any of the variables studied and flap viability. The functional result was considered adequate in 90% of cases and was associated with time of reconstruction.


CONCLUSIONS
Fibular-free-flap is a safe alternative in mandible reconstruction. Primary reconstruction offers better functional results.
Gallegos-Hernández
José Francisco
JF
Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México DF, México. gal61@prodigy.net.mx
Martinez-Miramón
Agustin
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D005360:Fibula / Q000637:transplantation*; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors