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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
A Journal on Maxillofacial Surgery
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2009 August;20(2):79-88
Posterolateral mandibular defect reconstruction with non-osseous free flaps in patients with advanced cancer: a 10-year retrospective study
Poli T., Ferrari S., Bianchi B., Balestreri A., Scozzafava E., Sesenna E.
Section of Maxillo-Facial Surgery, Department of ENT-Dentistry-Ophthalmological and Cervico-Facial Sciences, Azienda Ospedaliero-Universitaria di Parma, Italy
Aim. Soft tissue free flaps (forearm, rectus abdominis, and anterolateral thigh) are a good reconstruction choice for selected patients with advanced malignant tumors (stages III-IV) or recurrences following radiotherapy or chemotherapy, involving the posterolateral mandibular segments.
Methods. To evaluate the long-term aesthetic and functional results and possible complications of this reconstructive technique, we reviewed the data collected over a 10-year period on 30 patients with three-dimensional oromandibular defects.
Results. All free flaps were transferred successfully. Two patients (6,6%) died within the first two weeks, and 9 patients (30%) suffered early perioperative complications. No delayed complications were observed. An acceptable aesthetic and functional recovery was recorded in almost every case.
Conclusion. Although bone-containing free flaps are currently the gold standard in mandibular reconstruction, soft tissue free flaps are a good reconstruction option in selected cases (elderly patients, poor performance status, posterolateral oromandibular defects, and soft tissue defects exceeding bone loss)