Reconstruction with fibular osteocutaneous free flap in patients with mandibular osteoradionecrosis
김민균, 이승태, 박주용, 최성원,
소속 상세정보
김민균 ( Kim Min-Gyun ) - National Cancer Center Research Institute and Hospital Oral Oncology Clinic
이승태 ( Lee Seung-Tae ) - National Cancer Center Research Institute and Hospital Oral Oncology Clinic
박주용 ( Park Joo-Yong ) - National Cancer Center Research Institute and Hospital Oral Oncology Clinic
최성원 ( Choi Sung-Weon ) - National Cancer Center Research Institute and Hospital Oral Oncology Clinic
Abstract
Background: Osteoradionecrosis is a delayed complication from radiation therapy which causes chronic pain, infection and constant deformity after necrosis. Most of the osteoradionecrosis occurs spontaneously or after the primary oncologic surgery, dental extraction or by trauma of prosthesis. The treatment of osteoradionecrosis relies on both conservative measures and surgical measures. The fibular osteocutaneous free flap has become more popular choice for reconstruction of maxillofacial defects as a treatment of osteoradionecrosis.
Methods: We presented our experiences from 7 patients with osteoradionecrosis who have had reconstruction surgery with fibular osteocutaneous free flap at National Cancer Center during the recent 5 years. We performed segmental mandibular resection with fibular osteocutaneous free flap for all 7 patients of advanced osteoradionecrosis who were not controlled by conservative treatment such as wound irrigation, debridement, and antibiotics.
Results: A wide range of techniques were available for the reconstruction of composite defects resulted from the treatment of advanced mandibular osteoradionecrosis. Significant improvement was noted in relieving pain and treating trismus after the surgery however difficulty in swallowing and xerostomia showed less improvement.
Conclusions: We concluded that fibular osteocutaneous free flap can be performed safely in patients with osteoradionecrosis and yields positive outcomes with significantly increased success rate. The fibular osteocutaneous free flap was our preferred choice for the mandibular reconstruction due to its versatility and predictability.
키워드
Osteoradionecrosis; Mandible; Fibular; Radiation; Free flap
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