Fibula free flap in the treatment of mandibular osteoradionecrosis

Baron, S.; Salvan, D.; Cloutier, Lyne; Gharzouli, I.; Clerc, N.

doi:10.1016/j.anorl.2015.09.010

Cited by 17 publications

(9 citation statements)

References 14 publications

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“…Osteoradionecrosis (ORN) is a severe complication of radiotherapy in head and neck cancer patients. Up to 30% of the patients who undergo radiotherapy are affected by ORN, and at least, half of the patients who develop clinical signs and symptoms require surgical intervention (1,2). ORN has been described by Marx in 1983 as a chronic non-healing wound due to radiation causing hypoxic-hypocellular-hypovascular tissue, eventually leading to tissue breakdown.…”

Section: Introductionmentioning

confidence: 99%

Free vascularized flap reconstruction for osteoradionecrosis of the mandible: a 25-year retrospective cohort study

et al. 2022

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Background Osteoradionecrosis of the jaw is a severe complication of radiotherapy in head and neck cancer patients. If conservative treatment and surgical debridement have been unsuccessful, the preferred treatment for symptomatic mandibular osteoradionecrosis (mORN) is radical surgery and subsequent reconstruction with a free vascularized flap. This study aims to assess the outcomes of free vascularized flap reconstruction in mORN. Methods A retrospective study was conducted on all patients who underwent a free vascularized flap reconstruction for mORN between 1995 and 2021 in Amsterdam UMC – VUmc, The Netherlands. Results In our cohort study, three of the twenty-eight flap reconstructions failed (10.7%). No recurrences of mORN were observed during a mean follow-up of 8 years. Conclusions The success rate of free vascularized flap reconstruction for mORN is high. The fibula is the preferred free flap for mandibular reconstruction in mORN cases. However, this type of surgery is at risk for complications and patients need to be informed that these complications may require surgical re-intervention. Level of evidence: Level IV, Therapeutic; Risk/Prognostic.

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Section: Introductionmentioning

confidence: 99%

Free vascularized flap reconstruction for osteoradionecrosis of the mandible: a 25-year retrospective cohort study

et al. 2022

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“…The low scores of patients in mental health are largely related to the psychological reality of patients’ inability to accept jaw resection and their inability to adapt to changes in basic life functions such as speech and eating after surgery 19 . Patients are always worried about the recurrence of the tumor and the uncertainty of the future 20 , so they often experience symptoms such as irritability, fatigue, insomnia, pain, diarrhea and constipation 21 – 24 . This indicates that the emotional damage caused by the tumor to patients is more serious and long-lasting 25 .…”

Section: Discussionmentioning

confidence: 99%

The role of folded fibular flap in patients’ reconstruction of mandibular defects: a retrospective clinical study

Gao

Cai

et al. 2021

Sci Rep

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This study has analyzed 41 patients with mandibular ameloblastoma who underwent a partial mandibulectomy and reconstruction by folding the free fibular flap. In the preoperative and postoperative (6 months and 24 months after surgery), the Quality of Life (QOL) of these patients was assessed by using the University of Washington Quality of Life Questionnaire (UW-QOL) and the medical outcome study short form-36 (SF-36) questionnaires. SPSS 20.0 statistical software was used to conduct statistical analysis on the base data of the two groups of patients. Independent sample t test was conducted for sf-36 and UW-QOL scores at two time points in each group. The SF-36 survey showed that body pain (54.54 ± 8.10), general health (55.27 ± 7.54), and health changes (58.29 ± 9.60) decreased significantly at 6 months after surgery, but the mean score at 24 months after surgery all exceeded the preoperational level. At 24 months after the surgery, the vitality (80.41 ± 3.74), social function (81.61 ± 4.07), emotional role (82.39 ± 4.07), psychological health (81.66 ± 4.37) and total score (704.00 ± 31.53) all returned to the preoperative level, which was statistically significant compared with 6 months after surgery. However, there was no significant difference compared with the preoperative level. The UW-QOL survey showed that chewing (56.68 ± 7.23), speech (54.54 ± 7.7) and taste (62.29 ± 10.15) have significantly changed at 6 months after the surgery, and the difference was statistically significant at 24 months after surgery. Saliva generation decreased slightly (80.76 ± 3.35) at 6 months after surgery, but quickly returned to the preoperative level (81.59 ± 4.06). The total score of the patients almost recovered to the preoperative level at 24 months after surgery. The folded the fibular flap can not only repair the defects of soft tissue and bone tissue, but also restore the height of the alveolar ridge to, avoid the imbalance of crown and root ratio after implantation and reduce the occurrence of peri-implant inflammation, so that a true functional reconstruction can be realized.

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“…The low scores of patients in mental and mental health are largely related to the psychological reality of patients' inability to accept jaw resection and their inability to adapt to changes in basic life functions such as speech and eating after surgery 20 . Patients are always worried about the recurrence of the tumor and the uncertainty of the future 21 , so they often experience symptoms such as irritability, fatigue, insomnia, pain, diarrhea and constipation [22][23][24][25] . This indicates that the emotional damage caused by the tumor to patients is more serious and long-lasting 26 .…”

Section: Discussionmentioning

confidence: 99%

Reconstruction of mandible defect with folded free fibular flap

Gao¹,

Fu²,

Cai³

et al. 2021

Preprint

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Mandibular defects directly affect a patient’ facial features, masticatory and articulation. This study has analyzed 41 patients with mandibular ameloblastoma who underwent a partial mandibulectomy and reconstruction by folding the free fibular flap. In the preoperative and postoperative (6 months and 24 months after surgery), the QOL of these patients was assessed by using the University of Washington Quality of Life Questionnaire (UW-QOL) and the medical outcome study short form-36 (SF-36) questionnaires. The sf-36 survey showed that body pain, general health, and health changes decreased significantly at 6 months after surgery, but the mean score at 24 months after surgery all exceeded that shown before surgery. The UW-QOL survey showed that chewing, speech and taste had significantly changed in the 6 months after the surgery, and the difference was statistically significant 24 months after the surgery. The total score of the patients almost recovered to the preoperative level at 24 months after the surgery. The folded free fibular flap is an ideal selection for the reconstruction of oral defects after cancer resection. In using this flap, the basic social need of patients after surgery can be satisfied. The folded free fibular flap can improve the patients’ QOL.

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Fibula free flap in the treatment of mandibular osteoradionecrosis

Cited by 17 publications

References 14 publications

Free vascularized flap reconstruction for osteoradionecrosis of the mandible: a 25-year retrospective cohort study

Free vascularized flap reconstruction for osteoradionecrosis of the mandible: a 25-year retrospective cohort study

The role of folded fibular flap in patients’ reconstruction of mandibular defects: a retrospective clinical study

Reconstruction of mandible defect with folded free fibular flap

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