skip to main content
OSTI.GOV title logo U.S. Department of Energy
Office of Scientific and Technical Information

Title: Primary mandibular reconstruction: analysis of 64 cases and evaluation of interface radiation dosimetry on bridging plates

Abstract

The combination of a myocutaneous flap or free cutaneous tissue transfer with a three-dimensional bendable reconstruction plate either of stainless steel or titanium has provided very satisfactory results in primary restoration of mandibular defects following surgical resections in irradiated patients or in those who require postoperative radiotherapy. Sixty-four cases have been treated and evaluated prospectively using this technique. Fifty-three of the patients had the soft-tissue defect restored with a myocutaneous flap, 8 had a free cutaneous tissue flap, 2 were reconstructed with tongue flaps, and 1 closed primarily. The stainless steel plate of the A.O. type was used in 53 cases and the titanium plate system and hollow screws in the other 11 cases. A success rate of 78.9% was found with a median follow-up of 384 days. Thirty of the 64 cases had preoperative irradiation and 15 were treated postoperatively. A plate failure rate of 23% was encountered in those treated with preoperative irradiation and in 20% with those having postoperative irradiation. Forty-nine of the 64 patients or 76.5% experienced no perioperative complications. Five or 7.8% of the complications were minor. Ten patients or 15.6% experienced a major complication with one death due to a myocardial infarct. A radiationmore » dosimetric model was employed using both stainless steel and titanium. The results from this study showed that, when using a parallel pair of beams, an excess dose of irradiation for the lowest energy cobalt-60 is 13%, for 6 mV it is 15%, and for 18 mV it is 20%. The excess tissue dose, both for stainless steel and titanium plates, extends for about 0.2 mm for cobalt-60, 1.1 mm at 6 mV, and for 25 mm at 18 mV. Patients with plates, therefore, can be treated safely with postoperative irradiation using either cobalt-60 or 6-mV energy.« less

Authors:
 [1]
  1. Department of Otolaryngology, University of Toronto, Ontario (Canada)
Publication Date:
OSTI Identifier:
5591825
Resource Type:
Journal Article
Journal Name:
Laryngoscope; (United States)
Additional Journal Information:
Journal Volume: 101:6 Pt 2; Journal ID: ISSN 0023-852X
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; DOSIMETRY; MATHEMATICAL MODELS; JAW; PROSTHESES; BIOLOGICAL RADIATION EFFECTS; COBALT 60; DOSE-RESPONSE RELATIONSHIPS; RADIATION DOSES; SURVIVAL CURVES; TITANIUM; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BIOLOGICAL EFFECTS; BODY; COBALT ISOTOPES; DOSES; ELEMENTS; INTERMEDIATE MASS NUCLEI; INTERNAL CONVERSION RADIOISOTOPES; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICAL SUPPLIES; METALS; MINUTES LIVING RADIOISOTOPES; NUCLEI; ODD-ODD NUCLEI; ORGANS; RADIATION EFFECTS; RADIOISOTOPES; SKELETON; SKULL; TRANSITION ELEMENTS; YEARS LIVING RADIOISOT; 560151* - Radiation Effects on Animals- Man

Citation Formats

Gullane, P J. Primary mandibular reconstruction: analysis of 64 cases and evaluation of interface radiation dosimetry on bridging plates. United States: N. p., 1991. Web. doi:10.1288/00005537-199106000-00021.
Gullane, P J. Primary mandibular reconstruction: analysis of 64 cases and evaluation of interface radiation dosimetry on bridging plates. United States. https://doi.org/10.1288/00005537-199106000-00021
Gullane, P J. 1991. "Primary mandibular reconstruction: analysis of 64 cases and evaluation of interface radiation dosimetry on bridging plates". United States. https://doi.org/10.1288/00005537-199106000-00021.
@article{osti_5591825,
title = {Primary mandibular reconstruction: analysis of 64 cases and evaluation of interface radiation dosimetry on bridging plates},
author = {Gullane, P J},
abstractNote = {The combination of a myocutaneous flap or free cutaneous tissue transfer with a three-dimensional bendable reconstruction plate either of stainless steel or titanium has provided very satisfactory results in primary restoration of mandibular defects following surgical resections in irradiated patients or in those who require postoperative radiotherapy. Sixty-four cases have been treated and evaluated prospectively using this technique. Fifty-three of the patients had the soft-tissue defect restored with a myocutaneous flap, 8 had a free cutaneous tissue flap, 2 were reconstructed with tongue flaps, and 1 closed primarily. The stainless steel plate of the A.O. type was used in 53 cases and the titanium plate system and hollow screws in the other 11 cases. A success rate of 78.9% was found with a median follow-up of 384 days. Thirty of the 64 cases had preoperative irradiation and 15 were treated postoperatively. A plate failure rate of 23% was encountered in those treated with preoperative irradiation and in 20% with those having postoperative irradiation. Forty-nine of the 64 patients or 76.5% experienced no perioperative complications. Five or 7.8% of the complications were minor. Ten patients or 15.6% experienced a major complication with one death due to a myocardial infarct. A radiation dosimetric model was employed using both stainless steel and titanium. The results from this study showed that, when using a parallel pair of beams, an excess dose of irradiation for the lowest energy cobalt-60 is 13%, for 6 mV it is 15%, and for 18 mV it is 20%. The excess tissue dose, both for stainless steel and titanium plates, extends for about 0.2 mm for cobalt-60, 1.1 mm at 6 mV, and for 25 mm at 18 mV. Patients with plates, therefore, can be treated safely with postoperative irradiation using either cobalt-60 or 6-mV energy.},
doi = {10.1288/00005537-199106000-00021},
url = {https://www.osti.gov/biblio/5591825}, journal = {Laryngoscope; (United States)},
issn = {0023-852X},
number = ,
volume = 101:6 Pt 2,
place = {United States},
year = {Sat Jun 01 00:00:00 EDT 1991},
month = {Sat Jun 01 00:00:00 EDT 1991}
}