title: Reconstruction with fibular osteocutaneous free flap in patients with mandibular osteoradionecrosis.
abstract: BACKGROUND
  Osteoradionecrosis is a delayed complication from radiation therapy which causes chronic pain, infection and constant deformity after necrosis. Most of the osteoradionecrosis occurs spontaneously or after the primary oncologic surgery, dental extraction or by trauma of prosthesis. The treatment of osteoradionecrosis relies on both conservative measures and surgical measures. The fibular osteocutaneous free flap has become more popular choice for reconstruction of maxillofacial defects as a treatment of osteoradionecrosis.
  
  
  METHODS
  We presented our experiences from 7 patients with osteoradionecrosis who have had reconstruction surgery with fibular osteocutaneous free flap at National Cancer Center during the recent 5 years. We performed segmental mandibular resection with fibular osteocutaneous free flap for all 7 patients of advanced osteoradionecrosis who were not controlled by conservative treatment such as wound irrigation, debridement, and antibiotics.
  
  
  RESULTS
  A wide range of techniques were available for the reconstruction of composite defects resulted from the treatment of advanced mandibular osteoradionecrosis. Significant improvement was noted in relieving pain and treating trismus after the surgery however difficulty in swallowing and xerostomia showed less improvement.
  
  
  CONCLUSIONS
  We concluded that fibular osteocutaneous free flap can be performed safely in patients with osteoradionecrosis and yields positive outcomes with significantly increased success rate. The fibular osteocutaneous free flap was our preferred choice for the mandibular reconstruction due to its versatility and predictability.
authors: Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Il san east, Il san road 323, 2nd floor, Goyang, South Korea.
authors: Min Gyun
authors: MG
authors: Kim
authors: Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Il san east, Il san road 323, 2nd floor, Goyang, South Korea.
authors: Seung Tae
authors: ST
authors: Lee
authors: Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Il san east, Il san road 323, 2nd floor, Goyang, South Korea.
authors: Joo Yong
authors: JY
authors: Park
authors: Oral Oncology Clinic, Research Institute and Hospital, National Cancer Center, Il san east, Il san road 323, 2nd floor, Goyang, South Korea.
authors: Sung Weon
authors: SW
authors: Choi
keywords: Fibular; Free flap; Mandible; Osteoradionecrosis; Radiation