Abstract
ObjectivesThe purpose of this study was to evaluate the incidence of complications following mandibular reconstruction and to analyse possible contributing factors.Materials and methodsClinical data and computed tomography scans of all patients who needed a mandibular reconstruction with a reconstruction plate, free fibula flap (FFF) or iliac crest (DCIA) flap between August 2010 and August 2015 were retrospectively analysed.ResultsOne hundred and ninety patients were enrolled, encompassing 77 reconstructions with reconstruction plate, 89 reconstructions with FFF and 24 reconstructions with DCIA flaps. Cutaneous perforation was most frequently detected in the plate subgroup within the early interval and overall (each p = 0.004). Low body mass index (BMI) and total radiation dosage were the most relevant risk factors for the development of analysed complications.ConclusionsMicrovascular bone flaps have overall less skin perforation than reconstruction plates. BMI and expected total radiation dosage have to be respected in choice of reconstructive technique.Clinical relevanceA treatment algorithm for mandibular reconstructions on the basis of our results is presented.
Highlights
Mandibular reconstruction after partial or continuity resection is a complex procedure with non-negligible sequela on the Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Microvascular bone transplants like the free fibula flap (FFF) or iliac crest (DCIA) flap are reported to be safe reconstructive possibilities with transplant-specific advantages and disadvantages
Mandibular reconstruction is associated with complications, which might vary according to the reconstructive technique applied and the demanding patient cohort itself [11]
Any patient requiring a mandibulectomy and simultaneous reconstruction with a reconstruction plate, a FFF or a free iliac crest flap (DCIA) flap because of a benign or malign process between August 2010 and August 2015 at our department was included in this retrospective study
Summary
Microvascular bone transplants like the FFF or iliac crest (DCIA) flap are reported to be safe reconstructive possibilities with transplant-specific advantages and disadvantages. They are associated with good long-term results in specialized centres and have a reliable consistency of vertical. Mandibular reconstruction is associated with complications, which might vary according to the reconstructive technique applied and the demanding patient cohort itself [11]. Postoperative complications after reconstructive microsurgery are generally associated with prolonged inhospital stay, increased costs and prolonged treatment in the outpatient setting. This potentially reduces the quality of life in the synopsis
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