Comparison of Radial Forearm With Fibula and Scapula Osteocutaneous Free Flaps for Oromandibular Reconstruction

Militsakh, Oleg; Werle, Andreas H.; Mohyuddin, Nadia; Toby, E. Bruce; Kriet, J. David; Wallace, Derrick I.; Girod, Douglas A.; Tsue, Terance T.

doi:10.1001/archotol.131.7.571

Cited by 80 publications

(104 citation statements)

References 19 publications

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“…11 Proponents of the flap site the length and quality of bone stock available and the ease at which dental implants can be placed. Several studies however, have shown future dental implantation is infrequent in this patient population 9,12 and can be achieved with bone augmentation in OCRFFF reconstruction. 9 The thin pliable nature of the radial forearm flap with its superior soft tissue characteristics and lack of bulk allows for reconstruction of a variety of head and neck defects and prophylactic plating of the radius has reduced donor site morbidity associated with its use.…”

Section: Discussionmentioning

confidence: 94%

“…As a result, the OCRFFF has steadily gained popularity in mandibular reconstruction. 9,[12][13][14] In the present study we evaluated outcomes in patients undergoing free flap reconstruction of lateral segmental mandibular defects. Patients reconstructed with the OCRFFF required shorter hospital stays and demonstrated equivalent wound healing and functional results when compared to patients who underwent fibula free flap reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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Free Flap Reconstruction of Lateral Mandibular Defects: Indications and Outcomes

Dean¹,

Rosenthal²,

Virgin³

et al. 2011

Otolaryngol.--head neck surg.

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Objective-To compare outcomes following osteocutaneous radial forearm and fibula free flap reconstruction of lateral mandibular defects.Study Design-Retrospective case controlled study. Setting-Two academic tertiary care centers.Subjects and Methods-Patients who underwent free flap reconstruction of lateral mandibular defects from 1999 to 2010 were classified into four 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). Patient characteristics, length of hospital stay, recipient and donor site complications, and long term outcomes including postoperative diet were evaluated.Results-The majority of patients were male (67%) and presented with advanced T-stage (73%) squamous cell carcinoma (93%) involving the alveolus (26%) retromolar trigone (21%) or oral tongue (25%). Median length of hospital stay was 8 days (range 4-22). The recipient site complication rate approached 34% and included infection (n=11), mandibular malunion (n=9), exposed bone or mandibular plates (n=11) and flap failure (n=5). Most patients demonstrated little to no trismus following reconstruction (81%) and were able to resume a regular or edentulous diet (61%). No difference in complication rates or postoperative outcomes was seen between osteocutaneous radial forearm and fibula free flap groups (P > 0.05). One patient underwent dental implantation following osteocutaneous radial forearm free flap reconstruction. No patients from the fibula free flap group underwent dental implantation. Conclusion-The osteocutaneous radial forearm and fibula free flap provide equivalent wound healing and functional outcomes in patients undergoing lateral mandibular defect reconstruction.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Free Flap Reconstruction of Lateral Mandibular Defects: Indications and Outcomes

Dean¹,

Rosenthal²,

Virgin³

et al. 2011

Otolaryngol.--head neck surg.

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show abstract

“…[9][10][11][12][13] Our complication rates, and those previously reported in the literature, are summarized in Table 3. A previous publication by Militsakh et al 10 reports a retrospective review of patients from the University of Kansas Medical Center undergoing OCRFFF. Our 2 studies overlap slightly (2000)(2001)(2002)(2003); 50 patients were included in the present study and in the previously published article.…”

Section: Commentmentioning

confidence: 99%

Outcomes of the Osteocutaneous Radial Forearm Free Flap for Mandibular Reconstruction

Arganbright¹,

Tsue²,

Girod³

et al. 2013

JAMA Otolaryngol Head Neck Surg

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“…24,26) The fibular flap has excellent bone quality and quantity, up to 25 cm, of sufficient pedicle length. 23,26,27) Furthermore, the complication rates and donor site morbidity have generally been acceptable. The disadvantages of the flap are its associated skin paddle, which is of somewhat limited size and flexibility, 23,26) and the limited bone height availability of the osseointegrated implant flap.…”

Section: Carcinoma Involving the Mandiblementioning

confidence: 99%

Current Reconstructive Techniques Following Head and Neck Cancer Resection Using Microvascular Surgery

Kanazawa

Sarukawa

Fukushima

et al. 2011

Annals of Vascular Diseases

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Various techniques have been developed to reconstruct head and neck defects following surgery to restore function and cosmetics. Free tissue transfer using microvascular anastomosis has transformed surgical outcomes and the quality of life for head and neck cancer patients because this technique has made it possible for surgeons to perform more aggressive ablative surgery, but there is room for improvement to achieve a satisfactory survival rate. Reconstruction using the free tissue transfer technique is closely related to cardiovascular surgery because the anastomosis techniques used by head and neck surgeons are based on those of cardiovascular surgeons; thus, suggestions from cardiovascular surgeons might lead to further development of this field. The aim of this article is to present the recent general concepts of reconstruction procedures and our experiences of reconstructive surgeries of the oral cavity, mandible, maxilla, oropharynx and hypopharynx to help cardiovascular surgeons understand the reconstructions and share knowledge among themselves and with neck surgeons to develop future directions in head and neck reconstruction.

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Comparison of Radial Forearm With Fibula and Scapula Osteocutaneous Free Flaps for Oromandibular Reconstruction

Cited by 80 publications

References 19 publications

Free Flap Reconstruction of Lateral Mandibular Defects: Indications and Outcomes

Free Flap Reconstruction of Lateral Mandibular Defects: Indications and Outcomes

Outcomes of the Osteocutaneous Radial Forearm Free Flap for Mandibular Reconstruction

Current Reconstructive Techniques Following Head and Neck Cancer Resection Using Microvascular Surgery

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