Mandibular reconstruction with composite microvascular tissue transfer

Journal Article · Mon Oct 01 00:00:00 EDT 1990 · American Journal of Surgery; (USA)

DOI:https://doi.org/10.1016/S0002-9610(05)80550-1· OSTI ID:6320436

Coleman, III, J J; Wooden, W A ^[1]

---

1. Emory Univ. School of Medicine, Atlanta, GA (USA)

Microvascular free tissue transfer has provided a variety of methods of restoring vascularized bone and soft tissue to difficult defects created by tumor resection and trauma. Over 7 years, 26 patients have undergone 28 free flaps for mandibular reconstruction, 15 for primary squamous cell carcinoma of the floor of the mouth or tongue, 7 for recurrent tumor, and 6 for other reasons (lymphangioma (1), infection (1), gunshot wound (1), and osteoradionecrosis (3)). Primary reconstruction was performed in 19 cases and secondary in 9. All repairs were composite flaps including 12 scapula, 5 radial forearm, 3 fibula, 2 serratus, and 6 deep circumflex iliac artery. Mandibular defects included the symphysis alone (7), symphysis and body (5), symphysis-body-ramus condyle (2), body or ramus (13), and bilateral body (1). Fourteen patients had received prior radiotherapy to adjuvant or curative doses. Eight received postoperative radiotherapy. All patients had initially successful vascularized reconstruction by clinical examination (28) and positive radionuclide scan (22 of 22). Bony stability was achieved in 25 of 26 patients and oral continence in 24 of 26. One complete flap loss occurred at 14 days. Complications of some degree developed in 22 patients including partial skin necrosis (3), orocutaneous fistula (3), plate exposure (1), donor site infection (3), fracture of reconstruction (1), and fracture of the radius (1). Microvascular transfer of bone and soft tissue allows a reliable reconstruction--despite previous radiotherapy, infection, foreign body, or surgery--in almost every situation in which mandible and soft tissue are absent. Bony union, a healed wound, and reasonable function and appearance are likely despite early fistula, skin loss, or metal plate or bone exposure.

• OSTI ID: 6320436
• Journal Information: American Journal of Surgery; (USA), Journal Name: American Journal of Surgery; (USA) Vol. 160:4; ISSN 0002-9610; ISSN AJSUA
• Country of Publication: United States
• Language: English

Related Subjects

550600 -- Medicine
560151* -- Radiation Effects on Animals-- Man
62 RADIOLOGY AND NUCLEAR MEDICINE
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
BIOLOGICAL EFFECTS
BIOLOGICAL RADIATION EFFECTS
BIOLOGICAL RECOVERY
BODY
BODY AREAS
CARCINOMAS
DIGESTIVE SYSTEM
DISEASES
FACE
HEAD
HEALING
INJURIES
LOCAL RADIATION EFFECTS
MEDICINE
NECROSIS
NEOPLASMS
NUCLEAR MEDICINE
ORAL CAVITY
ORGANS
OSTEORADIONECROSIS
PATHOLOGICAL CHANGES
PATIENTS
RADIATION EFFECTS
RADIATION INJURIES
RADIOLOGY
RADIOTHERAPY
RECOVERY
SKELETAL DISEASES
SKELETON
SKIN
SURGERY
THERAPY
TONGUE
WOUNDS