Volume-Length Impact of Lateral Jaw Resections on Complication Rates

Arden, Richard L.; Rachel, John D.; Marks, Steven C.; Dang, Kulmeet

doi:10.1001/archotol.125.1.68

Cited by 68 publications

(57 citation statements)

References 14 publications

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“…7 Others have argued that placing a reconstruction plate across a lateral defect less than 5 cm will yield only a 5% to 10% long-term complication rate that includes plate fracture, intraoral or extraoral exposure, and loosening of the screws of the plate requiring surgical intervention. [8][9][10] Boyd et al 5 used a concept of "days of life lost" for time devoted to repairing failed reconstructions and came to the conclusion that even with a small complication rate for lateral defects, those patients who are young, fit, and not being palliated should receive an osteocutaneous reconstruction. When bolstered by a reconstruction plate, our data show that using the forearm osteocutaneous flap provides superior long-term results compared with historical controls using a soft tissue flap to cover the plate.…”

Section: Discussionmentioning

confidence: 99%

The indications and outcomes in the use of osteocutaneous radial forearm free flap

2003

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With rigid fixation of the residual radius, donor site morbidity has been minimized, and indications for this flap have expanded. Specifically the anterior maxillary arch and the ascending ramus, angle, and posterior body of the mandible (nontooth-bearing areas) are the sites most amenable to the thin bony stock of the harvested radius. The pliable forearm skin is ideal for the soft tissue defects. We believe that the RFOFF with bone has a definite role in the reconstruction of select head and neck defects.

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Section: Discussionmentioning

confidence: 99%

The indications and outcomes in the use of osteocutaneous radial forearm free flap

2003

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“…Unlike defects which involve the anterior mandibular arch, lateral defects result in disruption of the muscles of mastication and create an imbalance of the forces required to maintain mandibular form and function. A wide variety of reconstruction techniques have been described to restore continuity of the mandible including: nonvascular bone grafting, 1 mandibular bridging with reconstruction plates [2][3][4] and soft tissue or osteocutaneous free flap reconstruction. In a recent study by King et al, 5 patients who underwent vascularized bony reconstruction demonstrated improved functional results when compared to those who underwent soft tissue reconstruction alone.…”

Section: Introductionmentioning

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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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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“…Although some retrospective clinical studies recommended the use of a modified plate system (Stoll et al, 1992;Gellrich et al, 2004;Lopez et al, 2004), the rate of plate-related complications is still high (Freitag et al, 1991;Stoll et al, 1992;Lavertu et al, 1994;Boyd et al, 1995;Blackwell et al, 1996;Ueyama et al, 1996;Arden et al, 1999;Blackwell and Lacombe, 1999;Minnen et al, 2002;Wei et al, 2003;Lopez et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Adaquate fixation of plates for stability during mandibular reconstruction

Kimura

Nagasao

Kaneko

et al. 2006

Journal of Cranio-Maxillofacial Surgery

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Volume-Length Impact of Lateral Jaw Resections on Complication Rates

Abstract: Extirpative losses involving more than 5 cm of bone, or tissue volume greater than 240 cm3, are associated with unacceptably high complication rates when reconstructed with solid screw stainless steel plates and this warrants consideration of alternative techniques for long-term stability.

Cited by 68 publications

References 14 publications

The indications and outcomes in the use of osteocutaneous radial forearm free flap

The indications and outcomes in the use of osteocutaneous radial forearm free flap

Free Flap Reconstruction of Lateral Mandibular Defects: Indications and Outcomes

Adaquate fixation of plates for stability during mandibular reconstruction

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