Osteocutaneous free flaps for mandibular reconstruction: systematic review of their frequency of use and a preliminary quality of life comparison.
OBJECTIVE
To determine whether the fibula free flap is the most frequently used osteocutaneous flap for mandible reconstruction, and whether it provides quality of life, depression and anxiety advantages.


METHODS
A systematic review of the public Medline database was conducted. Thirteen patients who underwent mandibular reconstruction at our hospital centre completed questionnaires to evaluate quality of life, depression and anxiety outcomes.


RESULTS
The most frequently used free flaps are those of the fibula (n = 982), radial forearm (n = 201), iliac crest (n = 113), subscapular system (n = 50) and rib-serratus (n = 7). In our patient population, there was a trend towards a better quality of life in those with a fibula free flap. However, patients in this group were significantly younger than patients with other flap types (p = 0.025). Patients with a subscapular system free flap were more depressed (p = 0.031); however, they had large through-and-through defects.


CONCLUSIONS
The flap used most frequently in the literature is the fibula free flap. Comparative quality of life data are lacking, and homogeneous populations should be used to reach significant conclusions.
Otolaryngology-Head and Neck Surgery Service,Department of Surgery,Université de Montréal Hospital Center,Montreal,Canada.
S P
SP
Moubayed
Otolaryngology-Head and Neck Surgery Service,Department of Surgery,Université de Montréal Hospital Center,Montreal,Canada.
B
B
L'Heureux-Lebeau
Otolaryngology-Head and Neck Surgery Service,Department of Surgery,Université de Montréal Hospital Center,Montreal,Canada.
A
A
Christopoulos
Division of Surgical Research,McGill University,Montreal,Canada.
J S
JS
Sampalis
Department of Radiology,Université de Montréal Hospital Center,Montreal,Canada.
L
L
Letourneau-Guillon
Otolaryngology-Head and Neck Surgery Service,Department of Surgery,Université de Montréal Hospital Center,Montreal,Canada.
E
E
Bissada
Otolaryngology-Head and Neck Surgery Service,Department of Surgery,Université de Montréal Hospital Center,Montreal,Canada.
L
L
Guertin
Plastic and Reconstructive Surgery Service,Department of Surgery,Université de Montréal Hospital Center,Montreal,Canada.
P G
PG
Harris
Plastic and Reconstructive Surgery Service,Department of Surgery,Université de Montréal Hospital Center,Montreal,Canada.
A M
AM
Danino
Otolaryngology-Head and Neck Surgery Service,Department of Surgery,Université de Montréal Hospital Center,Montreal,Canada.
T
T
Ayad
D002294:Carcinoma, Squamous Cell / Q000601:surgery; D005360:Fibula / Q000637:transplantation; D058752:Free Tissue Flaps / Q000601:surgery*; D006258:Head and Neck Neoplasms / Q000601:surgery; D006801:Humans; D008334:Mandible / Q000601:surgery*; D063175:Mandibular Reconstruction / Q000379:methods*; D009062:Mouth Neoplasms / Q000601:surgery; D000077195:Squamous Cell Carcinoma of Head and Neck