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Management of advanced mandibular osteoradionecrosis with free flap reconstruction

✍ Scribed by David W. Chang; Hee-kyun Oh; Geoffrey L. Robb; Michael J. Miller

Publisher
John Wiley and Sons
Year
2001
Tongue
English
Weight
65 KB
Volume
23
Category
Article
ISSN
1043-3074

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✦ Synopsis

Abstract

Background

The purpose of this study was to assess the effectiveness of free tissue transfer for treatment of advanced mandibular osteoradionecrosis (ORN) in head and neck cancer patients.

Methods

We reviewed 29 patients who were treated for advanced mandibular ORN by radical resection and reconstruction with free flaps at our institution. All patients had either failed to respond to conservative treatment, including hyperbaric oxygen therapy and debridement or had pathological fracture due to ORN.

Results

Twenty‐four vascularized bone (17 fibula, five iliac, and two scapula), four rectus abdominis myocutaneous, and one radial forearm fasciocutaneous free flaps were used. The complications occurred in 6 of 29 patients (21%). A total of four flaps (14%) were lost. The mean follow‐up was 2 years 9 months. All patients had complete resolution of ORN symptoms. No evidence of ORN recurrence was observed in any patient.

Conclusion

For advanced osteoradionecrosis of the mandible, radical resection followed by reconstruction using free flap provides a reliable means of obtaining good wound healing with acceptable aesthetic and functional results. Β© 2001 John Wiley & Sons, Inc. Head Neck 23: 830–835, 2001.

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