Distraction osteogenesis; an option following failed bony free flaps in head and neck reconstruction

Abstract

Introduction: Primary reconstruction of the mandible with bony free flaps is a predictable technique with high success rates. However, failure of composite flaps do occur, and can pose a difficult situation for patient and surgeon. Options may include further flap procedures, alloplastic replacement and opting for non-bony reconstructions. These all have limitations. Challenges of reconstruction in salvage cases include an irradiated field, sequalae from primary procedures, and development of adequate bone and quality soft tissue for dental rehabilitation. Distraction osteogenesis (DO), has been long utilised in maxillofacial surgery and presents one further option to be considered in such cases.