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Revista Española de Cirugía Oral y Maxilofacial

On-line version ISSN 2173-9161Print version ISSN 1130-0558


INFANTE COSSIO, P. et al. Fibular osteoseptocutaneous free flap in the primary reconstruction after massive radionecrosis of the mandible. Rev Esp Cirug Oral y Maxilofac [online]. 2004, vol.26, n.3, pp.178-186. ISSN 2173-9161.

Abstract: Osteoradionecrosis is one of the most serious complications after radiation therapy of squamous carcinoma of the oral cavity. In this article, we report four cases of massive osteoradionecrosis of the mandible, all of whom had failed initial conservative management and treated with radical resection and primary reconstructed with fibular osteoseptocutaneous free flap. Mandible defects after radical resection were around 10 cm long and included intraoral mucosa, skin or both. A doubled-paddle peroneal tissue transfer was used in two cases for reconstruction of an extensive extra- or intraoral defects. The vascularized fibular flap was osteotomized in all cases to permit contouring the mandibular defect. All the flaps survived completely. Three patients healed primarily with good aesthetic and functional results. One patient died one month after the operation due to an acute pancreatitis and renal failure. One patient had placement of osseointegrated implants. In our experience, the fibular osteoseptocutaneous free flap can be an ideal option for one stage reconstruction of complex, composite mandibular defects in patients with massive osteoradionecrosis.

Keywords : Osteoradionecrosis; Mandible; Microvascular surgery; Fibular free plap.

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