The Free Flap and Plate in Oromandibular Reconstruction

Jb, Boyd; Rs, Mulholland; Davidson, John S.; Pj, Gullane; Le, Rotstein; Dh, Brown; Je, Freeman; Jc, Irish

doi:10.1097/00006534-199505000-00010

Cited by 183 publications

(161 citation statements)

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“…In cases of defects crossing the midline, the muscles of floor of the mouth and tongue lose their insertion to the mandible and may result in plate exposure [20]. In addition the mobility of muscle and mucosa in this region due to tongue movement is another probable cause.…”

Section: Discussionmentioning

confidence: 99%

“…Studies on comparison of small plates and reconstruction plates showed advantages of small plates over reconstruction plates for graft fixation, as removal of the former is not always necessary, inturn small plates due to their lower profile interfere less with dentures and implant placement [20,21]. Further maxillomandibular fixation post operatively will help in minimizing movement of soft tissue over the graft and the hardware.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Non-vascular Fibula Graft for Mandibular Reconstruction

Devireddy

Murugan

Kumar

et al. 2014

J. Maxillofac. Oral Surg.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Evaluation of Non-vascular Fibula Graft for Mandibular Reconstruction

Devireddy

Murugan

Kumar

et al. 2014

J. Maxillofac. Oral Surg.

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“…10 As an alternative, a number of reports have supported the use of a reconstruction plate combined with soft tissue coverage to reconstruct pure lateral mandibular defect. [11][12][13] The advantages of using prosthetic materials are obvious: ease of application and shaping, decreased operative time, donor site sparing, and immediate full-strength masticatory function. Furthermore, delayed reconstruction with vascularized bone is possible.…”

Section: Introductionmentioning

confidence: 99%

The Free Vascularized Flap and the Flap Plate Options: Comparative Results of Reconstruction of Lateral Mandibular Defects

Shpitzer¹,

Gullane

Neligan³

et al. 2000

The Laryngoscope

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Objectives/Hypothesis: Reconstruction of the mandible and oral cavity after segmental resection is a challenging surgical problem. Although osteocutaneous free flaps are generally accepted to be optimal for reconstruction of anterior defects, the need for bony reconstruction for a pure lateral mandibular defect remains controversial. Study Design: A retrospective study. Methods: A retrospective comparative study of short-and long-term outcomes of three different reconstruction techniques for lateral defects was performed. In total, 57 patients were included, of whom 27 had a plate and pedicled pectoralis major myocutaneous flap (PMMF group), 16 had a plate and free radial forearm flap (FRFF group), and 14 had an osteocutaneous free flap. Functionality, flap failure, and complications were scored. Results: Plates had to be removed in 7 of the 27 patients in the PMMF group and 2 of the 16 in the FRFF group; none of the 14 osteocutaneous free flaps failed. The difference was of borderline statistical significance (P ‫؍‬ .055). Longterm functional outcome revealed no statistically significant difference in oral deglutition (P ‫؍‬ .76) or in facial contour (P ‫؍‬ .36). Oral continence was significantly better in patients in the FRFF group (88%) as compared with the PMMF group (52%) or the osteocutaneous free flap group (43%) (P ‫؍‬ .02). On the other hand, the results for speech favored the osteocutaneous free flap group; 13 of 14 patients (92.9%) had a normal score compared with 12 of 16 patients (75%) in the FRFF group and 17 of 27 (63%) in the PMMF group. However, this represented a borderline statistically significant result (P ‫؍‬ .06). Conclusions: For lateral mandibular defects, the osteocutaneous free flap is reliable and durable in the long term. However, in a selected group of patients either of the two flapplate options is a viable reconstructive option. Key Words: Lateral mandibular defect, osteocutaneous free flap, flap and plate.

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“…The results from the use of titanium reconstructive plates are very encouraging in large series of patients 10,11,13,14 . Koch and co authors in a retrospective review of 40 patients promote the titanium reconstructive plate as a permanent method of mandibular reconstruction.…”

Section: Discussionmentioning

confidence: 98%

“…If the mandible is also resected, reconstructive plate or bone grafts had to be used to provide substance and profile and also mastication, deglutition, phonation 10,11 . There are several reports in the literature on the therapeutic results after the use of pectoralis major flap 4,5,12 and its advantages are numerous, but when it is not indicated or cannot be used as in our case because we already used it in the first surgery and now it was invaded, lattisimus dorsi Figure 6.…”

Section: Discussionmentioning

confidence: 99%