A Comprehensive Analysis of Complications of Free Flaps for Oromandibular Reconstruction

2021 ◽  
Author(s):  
Amit Walia ◽  
Joshua Mendoza ◽  
Craig A. Bollig ◽  
Ethan J. Craig ◽  
Ryan S. Jackson ◽  
...  
Keyword(s):  
Free Flaps ◽  
Comprehensive Analysis ◽  
Oromandibular Reconstruction

scholarly journals Sequela de cirurgia para reconstrução mandibular após ressecção de ameloblastoma

2019 ◽  
Vol 8 (8) ◽  
Author(s):  
Allancardi dos Santos Siqueira ◽  
Luiz Henrique Soares Torres ◽  
Jiordanne Araújo Diniz ◽  
Éwerton Daniel Rocha Rodrigues ◽  
Caio Pimenteira Uchôa ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Free Flap ◽  
Platelet Rich Plasma ◽  
Treatment Algorithm ◽  
Free Flaps ◽  
Mandibular Reconstruction ◽  
Benign Tumors ◽  
New Classification ◽  
Oromandibular Reconstruction ◽  
Head Neck

Os defeitos mandibulares devido à ressecção de lesão óssea interferem a harmonia e estética facial comprometendo a qualidade de vida dos pacientes. Grandes defeitos exigem planejamento minucioso, principalmente quando lançamos mão de enxertos e placas de reconstrução, evitando assim resultados insatisfatórios ou até mesmo sequelas. Apesar de algumas classificações dos defeitos mandibulares vêm sendo discutidas ao longo dos anos, ainda não há um protocolo definido para reconstrução mandibular. O uso de prototipagem na Cirurgia Bucomaxilofacial tem se tornado cada vez mais frequente; a precisão da reconstrução, diminuição do tempo de cirurgia reflete em recuperação mais rápida do paciente. Mesmo com a ferramenta da prototipagem, grandes lesões e perdas ósseas permanecem como grande desafio ao cirurgião.  O objetivo deste trabalho é relatar um caso clínico de reconstrução mandibular no qual houve a necessidade de ser tratado com remoção de placa de reconstrução e nova reabilitação cirúrgica do paciente.Descritores: Mandíbula; Reconstrução Mandibular; Modelos Biológicos.ReferênciasSantos LCS, Seixas AM, Barbosa B, Cincura RNS. Adaptação de placas reconstrutivas: uma nova técnica. Rev Cir Traumatol Buco-Maxilo-Fac. 2011;11(2):9-14.Lin PY, Lin KC, Jeng SF. Oromandibular reconstruction: the history, operative options and strategies, and our experience. ISRN Surg. 2011;2011:824251.Martins Jr. JC, Keim FS. Uso de prototipagem no planejamento de reconstrução microcirúrgica da mandíbula. Rev Bras Cir Craniomaxilofac. 2011;14(4):225-28.Montoro JR, Tavares MG, Melo DH, Franco Rde L, Mello-Filho FV, Xavier SP, Trivellato AE, Lucas AS. Mandibular ameloblastoma treated by bone resection and imediate reconstruction. Braz J Otorhinolaryngol. 2008;74(1):155-57.Nóia CF, Ortega-Lopes R, Chaves Netto HDM, Nascimento FFAO, Sá BCM. Desafios na reconstrução mandibular devido a lesões extensas ou traumatismos. Rev Assoc Paul Cir Dent. 2015;69(2):158-63.Cohen A, Laviv A, Berman P, Nashef R, Abu-Tair J. Mandibular reconstruction using stereolithographic 3-dimensional printing modeling technology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108(5):661-6.Rana M, Warraich R, Kokemüller H,  Lemound J,  Essig H, Tavassol F et al. Reconstruction of mandibular defects - clinical retrospective research over a 10-year period. Head Neck Oncol. 2011;3:23.Fariña R, Alister JP, Uribe F, Olate S, Arriagada A. Indications of Free Grafts in Mandibular Reconstruction, after Removing Benign Tumors: Treatment Algorithm. Plast Reconstr Surg Glob Open. 2016;4(8):e845.Fariña R, Plaza C, Martinovic G. New transference technique of position of mandibular reconstructing plates using stereolithographic models. J Oral Maxillofac Surg. 2009;7(11):2544-48.Mooren RE, Merkx MA, Kessler PA, Jansen JA, Stoelinga PJ. Reconstruction of the mandible using preshaped 2.3-mm titanium plates, autogenous cortical bone plates, particulate cancellous bone, and platelet-rich plasma: a retrospective analysis of 20 patients. J Oral Maxillofac Surg. 2010;68(10):2459–67.Brown JS, Barry C, Ho M, Shaw R.A new classification for mandibular defects after oncological resection. Lancet Oncol. 2016;17(1):23-30Urken ML, Weinberg H, Vickery C, Buchbinder D, Lawson W, Biller HF. Oromandibular reconstruction using microvascular composite free flaps. Report of 71 cases and a new classification scheme for bony, soft-tissue, and neurologic defects. Arch Otolaryngol Head Neck Surg. 1991;117(7):733-44.Shnayder Y, Lin D, Desai SC, Nussenbaum B, Sand JP, Wax MK. Reconstruction of the Lateral Mandibular Defect: A Review and Treatment Algorithm. JAMA Facial Plast Surg. 2015;17(5):367-73.Wei FC, Celik N, YangWG, Chen IH, Chang YM, Chen HC. Complications after reconstruction by plate and soft-tissue free flap in composite mandibular defects and secondary salvage reconstruction with osteocutaneous flap. Plast Reconstr Surg. 2003;112(1):37-42.Li BH, Jung HJ, Choi SW, Kim SM, Kim MJ, Lee JH. Latissimus dorsi (LD) free flap and reconstruction plate used for extensive maxillo-mandibular reconstruction after tumour ablation. J Craniomaxillofac Surg. 2012;40(8):293-300.

scholarly journals Comparison of Radial Forearm With Fibula and Scapula Osteocutaneous Free Flaps for Oromandibular Reconstruction

2005 ◽  
Vol 131 (7) ◽  
pp. 571 ◽  
Author(s):  
Oleg N. Militsakh ◽  
Andreas Werle ◽  
Nadia Mohyuddin ◽  
E. Bruce Toby ◽  
J. David Kriet ◽  
...  
Keyword(s):  
Free Flaps ◽  
Radial Forearm ◽  
Oromandibular Reconstruction

Primary oromandibular reconstruction using free flaps and thorp plates in cancer patients: A 5-year experience

Head & Neck ◽  
2002 ◽  
Vol 25 (1) ◽  
pp. 15-23 ◽  
Author(s):  
Tito Poli ◽  
Silvano Ferrari ◽  
Bernardo Bianchi ◽  
Enrico Sesenna
Keyword(s):  
Cancer Patients ◽  
Free Flaps ◽  
Oromandibular Reconstruction

scholarly journals Dynamic Oromandibular Reconstructions Using Chimeric Fibular and Gracilis or Vastus Lateralis Free Flaps

2020 ◽  
Vol 05 (02) ◽  
pp. e36-e42
Author(s):  
Min Ji Kim ◽  
Jong Woo Choi ◽  
Woo Shik Jeong ◽  
Soon Yuhl Nam ◽  
Seung Ho Choi
Keyword(s):  
Free Flap ◽  
Vastus Lateralis ◽  
Retrospective Chart Review ◽  
Free Flaps ◽  
Control Group ◽  
Vastus Lateralis Muscle ◽  
Free Fibular Flap ◽  
Dynamic Group ◽  
Fibular Flap ◽  
Oromandibular Reconstruction

Abstract Background Despite efforts of head and neck functional reconstruction, anatomic restoration has been used until now. This article describes our experience of using a chimeric free fibular osteocutaneous flap conjoined with a functional muscle free flap, defined as dynamic oromandibular reconstruction. Methods Through a retrospective chart review, four consecutive patients who underwent reconstruction with a total fibular free flap were included. The former two patients underwent reconstruction using a conventional osteocutaneous free fibular flap. The latter two patients had an oromandibular defect after cancer resection and underwent dynamic oromandibular reconstruction with a chimeric free fibular flap conjoined with a gracilis free flap or vastus lateralis muscle free flap. Results In the speech analysis, the dynamic group revealed a satisfactory tongue movement. Protrusion and lateralization were the most different movement changes. The tongue range of motion score was 62.5 in the dynamic group and 25.0 in the control group. On the dynamic magnetic resonance imaging, the contact of the soft palate with the tongue was excellent, and the epiglottis closure during deglutition was complete. In the three-dimensional volumetric analysis of mandibular aesthetic contouring, the dynamic group showed a much smaller difference in hemifacial volume, with a difference of 73.7 mL in the dynamic group and 101.76 mL in the control group. Conclusion This study is a preliminary trial of dynamic oromandibular reconstruction using chimeric free fibular flaps with functional muscle transfer. We demonstrated the possibility of dynamic oromandibular reconstruction, which enhanced more functional aspects in the patients in this study.

Cephalometric and Functional Mandibular Reconstructive Outcomes Using a Horizontal Scapular Tip Free Flap

2021 ◽  
pp. 019459982098413
Author(s):  
Cameron Charles Sheehan ◽  
Angela D. Haskins ◽  
Andrew T. Huang ◽  
David J. Hernandez
Keyword(s):  
Surgical Planning ◽  
Free Flaps ◽  
Head And Neck Reconstruction ◽  
Flap Survival ◽  
Neck Reconstruction ◽  
Virtual Surgical Planning ◽  
Horizontal Orientation ◽  
Cephalometric Measurements ◽  
Oromandibular Reconstruction ◽  
Oral Diet

Scapula tip free flaps (STFFs) have become an increasingly popular option for head and neck reconstruction. The aim of this study is to demonstrate the feasibility of using the STFF in a horizontal orientation to take advantage of the anatomy of the scapular tip bone to re-create a mandibular symphysis. Eight patients underwent oromandibular reconstruction with a horizontally oriented STFF between October 2016 and June 2020. Virtual surgical planning was used to design the bony reconstruction in 6 cases. Primary outcomes, including flap survival, complications, and return to oral diet, were collected. Cephalometric measurements were obtained to compare preoperative and postoperative mandibular projection and width. All flaps survived without compromise, and no fistulas developed postoperatively. Seven patients returned to taking an oral diet. Cephalometric analysis revealed comparable measurements between preoperative and postoperative mandibles and reconstructed mandibles, respectively. STFFs may be oriented horizontally to reconstruct large anterior mandibular defects with satisfactory results.

scholarly journals Comparison of Fibular and Scapular Osseous Free Flaps for Oromandibular Reconstruction

2013 ◽  
Vol 139 (3) ◽  
pp. 285 ◽  
Author(s):  
Samuel A. Dowthwaite ◽  
Julie Theurer ◽  
Mathieu Belzile ◽  
Kevin Fung ◽  
Jason Franklin ◽  
...  
Keyword(s):  
Free Flaps ◽  
Oromandibular Reconstruction

scholarly journals Oromandibular reconstruction with free fibula osteocutaneous flap after oncologic resection: retrospective analysis of surgical experience and operative outcome of 56 cases

2019 ◽  
Vol 6 (10) ◽  
pp. 3674
Author(s):  
Shobhit Sharma ◽  
Sudipta Bera
Keyword(s):  
Free Tissue Transfer ◽  
Free Flaps ◽  
Aesthetic Outcome ◽  
Food Tolerance ◽  
Oncologic Resection ◽  
Aesthetic Results ◽  
Reconstructive Option ◽  
Free Fibula ◽  
Osteocutaneous Flap ◽  
Oromandibular Reconstruction

Background: Reconstruction of post oncologic resection oromandibular defect is challenging and it provides the base for subsequent radiotherapy and oromaxillary rehabilitation for functional and aesthetic outcome. Multiple reconstructive options including different free flaps exist in the present time of greater awareness, facility and expertise in the field of free tissue transfer surgery. But free fibula osteocutaneous flap (FFOCF) has been the state of art in this area. FFOCF is technically difficult but believed to be reliable even to start with and has a progressively comprehensive surgical technique and learning curve. We are presenting here our experience of FFOCF reconstruction of 56 cases over the last 3 years.Methods: 56 patients operated between 2015 to 2018 were assessed retrospectively for operative and surgical outcome.Results: Flap was successful in 54 (96.43%) cases. Re-exploration was done in 4 cases and was successful in 2 cases. Jaw shape and contour was satisfactory in 70.37% and solid food tolerance was noted in 80.35% cases. Recurrence was seen in 5 cases.Conclusions: FFOCF is a reliable reconstructive option for complex oromandibular defect with a predictable outcome. Flap harvest is reliable and contouring is comprehensive. It gives good functional and aesthetic results with high success rate. Thus this flap is truly the preferred reconstructive option for all type of oncologic oromandibular defect with micro vascular surgery facilities.

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