Open AccessFree Flap Reconstruction of Lateral Mandibular Defects: Indications and Outcomes
Author(s) -
Dean Nichole R.,
Rosenthal Eben L.,
Virgin Frank,
Magnuson J. Scott,
Wax Mark K.,
Carroll William R.
Publication year - 2011
Publication title -
otolaryngology–head and neck surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.232
H-Index - 121
eISSN - 1097-6817
pISSN - 0194-5998
DOI - 10.1177/0194599811416318a21
Subject(s) - medicine , free flap , trismus , forearm , surgery , fibula , malunion , complication , nonunion , tibia
Objective To evaluate outcomes following lateral mandibular defect free flap reconstruction. Method Patients undergoing lateral mandibular defect free flap reconstruction from 1999 to 2010 at 2 tertiary care centers were classified into 4 groups based on type of reconstruction: 1) radial forearm swing (n = 8), 2) radial forearm with bar (n = 5), 3) osteocutaneous radial forearm (n = 73) and 4) fibula free flap reconstruction (n = 51). Results The majority of patients were male (67%) and presented with advanced T‐stage (59%) squamous cell carcinoma (93%) involving the alveolus (26%) retromolar trigone (21%) or oral tongue (25%). The recipient site complication rate approached 35% and included infection and mandibular malunion (n = 9), exposed bone or mandibular plates (n = 7), venous congestion (n = 2), and flap failure (n = 6). Most patients demonstrated little to no trismus following reconstruction (81%) and were able to resume a regular or soft diet (61%). No difference in complication rates, hospital stay or postoperative outcomes was seen between osteocutaneous radial forearm and fibula free flap groups ( P >. 05). Conclusion Free flap reconstruction of lateral mandibular defects results in acceptable functional outcomes for the majority of patients including those who undergo osteocutaneous radial forearm free tissue transfer.