ORIGINAL ARTICLES   

Italian Journal of Maxillofacial Surgery 2009 August;20(2):79-88

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: English

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)