title: Mandibular osteoradionecrosis: use of sequential fibula free flaps for a remote sequence of complications.
abstract: Mandibular osteoradionecrosis is a serious complication of radiotherapy that often leads to severe facial deformity, intolerable pain, fracture, sequestration of devitalized bone and fistulas. The prophylaxis of this severe complication is a major goal in modern combined tumor therapy, but once the pathology is established, conservative treatment modalities are used in almost all patients in an effort to control progression. Radical surgery should only be instituted when conservative methods fail or when severe bone and soft-tissue necrosis prevails. Pathologic fractures and chronic fistulae are clear indicators for radical surgical management. This paper document a case report of severe bilateral mandibular osteoradionecrosis reconstructed with two sequencial osteocutaneous fibular free flap. The authors discuss the different alternatives of treatment and the most important steps for a successful management of this challenge.
authors: Department of Oral and Maxillofacial Surgery, La Paz University Hospital, Madrid, Spain.
authors: L Pingarrón
authors: LP
authors: Martín
authors: L J Arias
authors: LJ
authors: Gallo
authors: M Chamorro
authors: MC
authors: Pons
authors: M J Morán
authors: MJ
authors: Soto
authors: J L Cebrián
authors: JL
authors: Carretero
authors: M Burgueño
authors: MB
authors: García