Outcomes of osseous free flap reconstruction in stage III bisphosphonate-related osteonecrosis of the jaw: Systematic review and a new case series

2014 ◽  
Vol 42 (5) ◽  
pp. 377-386 ◽  
Author(s):  
Herman Vercruysse ◽  
Tom de Backer ◽  
Maurice Y. Mommaerts
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Case Series ◽  
Osteonecrosis Of The Jaw ◽  
Stage Iii ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction

scholarly journals Microsurgical Reconstruction of the Jaws Using Vascularised Free Flap Technique in Patients with Medication-Related Osteonecrosis: A Systematic Review

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Roberto Sacco ◽  
Nicola Sacco ◽  
Umar Hamid ◽  
Syed Hasan Ali ◽  
Mark Singh ◽  
...  
Keyword(s):  
Success Rate ◽  
Free Flap ◽  
Vascular Reconstruction ◽  
Osteonecrosis Of The Jaw ◽  
Stage Iii ◽  
Reconstruction Technique ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Fibula Free Flap ◽  
Based Medicine

Background. Osteonecrosis of the jaw (ONJ) has been reported to be associated with patients receiving primarily bisphosphonate (BP) therapies. However, lately it has been documented that other medications, such as RANK ligand inhibitor (denosumab) and antiangiogenic drug, can cause ONJ. Micro-osseous-vascular reconstruction of the jaws in patients affected by medication-related osteonecrosis of the jaw represents a viable option of treatment for patients affected by stage III of the disease. However, there are still considerable doubts about the success of this procedure in the short, medium, and long term. Material and Methods. A multidatabase (PubMed/MEDLINE, EMBASE, and CENTRAL) systematic search was performed. Any type of studies considering human patients treated with antiresorptive and antiangiogenic drugs was considered. The aim of the research is to primarily understand the success rate of micro-osseous-vascular reconstruction in the short, medium, and long period of time. This review has also the goal of better understanding any perioperative and postoperative complications resulting from the use of the reconstruction techniques. Results. Eighteen studies resulted eligible for the study. Fibula free flap is the most commonly utilised vascularised free flap reconstruction technique (80.76%). Ten out of eighteen studies reported no complications. Recurrence of osteonecrosis was registered in five cases (6.41%) after free flap reconstruction. The overall free flap success rate was 96.16%. Conclusions. Based on the limited data available in literature (Level 4 of the Oxford Evidence-based medicine scale), micro-osseous-vascular reconstruction of the jaws represents a valid treatment in patients with bisphosphonate-related osteonecrosis at stage III of the disease. However, additional data based on a larger cohort of patients are necessary to justify this type of intervention in patient affected by MRONJ.

Free Flap Reconstruction of the Anterior Skull Base: A Systematic Review

2021 ◽  
Author(s):  
Rajan P. Dang ◽  
Abhinav R. Ettyreddy ◽  
Zain Rizvi ◽  
Michelle Doering ◽  
Angela L. Mazul ◽  
...  
Keyword(s):  
Systematic Review ◽  
Skull Base ◽  
Free Flap ◽  
High Reliability ◽  
Anterior Skull Base ◽  
Microvascular Reconstruction ◽  
Complication Rates ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Comprehensive Search

Abstract Objectives Given the limitations in the available literature, the precise indications, techniques, and outcomes of anterior skull base free flap reconstruction remain uncertain. The objective of this study was to perform a systematic review of published literature and evaluate indications, methods, and complications for anterior skull base free flap reconstruction. Methods A systematic review of the literature was performed using a set of search criteria to identify patients who underwent free flap reconstruction of the anterior skull base. Articles were reviewed for inclusion based on relevance, with the primary outcome being surgical complications. Results After a comprehensive search, 406 articles were obtained and 16 articles were ultimately found to be relevant to this review—79 patients undergoing free flap reconstruction were identified. Overall complication rates were 17.7% (95% confidence interval [CI]: 16.6–33.1%) for major complications and 19.0% (95% CI: 17.8–35.5%) for minor complications. Conclusion Microvascular reconstruction of the anterior skull base is feasible with high reliability reported in the literature.

scholarly journals A systematic review of validated tools assessing functional and aesthetic outcomes following fibula free flap reconstruction of the mandible

Head & Neck ◽  
2018 ◽  
Author(s):  
Ivana Petrovic ◽  
Hina Panchal ◽  
Paula Demetrio De Souza Franca ◽  
Marisol Hernandez ◽  
Colleen C. McCarthy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Fibula Free Flap

scholarly journals Protocol for a systematic review of venous coupler devices versus hand-sewn anastomosis for microsurgical free flap reconstruction

2018 ◽  
Vol 7 (1) ◽  
Author(s):  
Timo Rodi ◽  
Alexander Geierlehner ◽  
Afshin Mosahebi ◽  
Grigorios Tanos ◽  
Justin Conrad Rosen Wormald
Keyword(s):  
Systematic Review ◽  
Free Flap ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction

scholarly journals Postoperative care in microvascular free flap reconstruction of the lower extremity: A systematic review

2020 ◽  
Vol 1-2 ◽  
pp. 21-26
Author(s):  
David D. Krijgh ◽  
Milou M.E. van Straeten ◽  
Marc A.M. Mureau ◽  
Antonius J.M. Luijsterburg ◽  
Pascal P.A. Schellekens ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lower Extremity ◽  
Free Flap ◽  
Postoperative Care ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Microvascular Free Flap

scholarly journals Use of the Anterolateral Thigh in Cranio-Orbitofacial Reconstruction

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
William J. Parkes ◽  
Howard Krein ◽  
Ryan Heffelfinger ◽  
Joseph Curry
Keyword(s):  
Free Flap ◽  
Case Series ◽  
Free Tissue Transfer ◽  
Free Flaps ◽  
Tissue Loss ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Anterolateral Thigh ◽  
The Many ◽  
Soft Tissue Loss

Objective. To detail the clinical outcomes of a series of patients having undergone free flap reconstruction of the orbit and periorbita and highlight the anterolateral thigh (ALT) as a workhorse for addressing defects in this region. Methods. A review of 47 patients who underwent free flap reconstruction for orbital or periorbital defects between September 2006 and May 2011 was performed. Data reviewed included demographics, defect characteristics, free flap used, additional reconstructive techniques employed, length of stay, complications, and follow-up. The ALT subset of the case series was the focus of the data reviewed for this paper. Selected cases were described to highlight some of the advantages of employing the ALT for cranio-orbitofacial reconstruction. Results. 51 free flaps in 47 patients were reviewed. 38 cases required orbital exenteration. The ALT was used in 33 patients. Complications included 1 hematoma, 2 wound infections, 3 CSF leaks, and 3 flap failures. Conclusions. Free tissue transfer allows for the safe and effective reconstruction of complex defects of the orbit and periorbital structures. Reconstructive choice is dependent upon the extent of soft tissue loss, midfacial bone loss, and skullbase involvement. The ALT provides a versatile option to reconstruct the many cranio-orbitofacial defects encountered.

Enhanced recovery after surgery for head and neck free flap reconstruction: A systematic review and meta-analysis

Oral Oncology ◽  
2021 ◽  
Vol 113 ◽  
pp. 105117
Author(s):  
Kevin Chorath ◽  
Beatrice Go ◽  
Justin R. Shinn ◽  
Leila J. Mady ◽  
Seerat Poonia ◽  
...  
Keyword(s):  
Systematic Review ◽  
Head And Neck ◽  
Free Flap ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Meta Analysis ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction

scholarly journals Naso- or Orbitocutaneous Fistulas after Free Flap Reconstruction of Orbital Exenteration Defects: Retrospective Study, Systematic Review, and Meta-Analysis

2017 ◽  
Vol 78 (04) ◽  
pp. 337-345 ◽  
Author(s):  
Kurren Gill ◽  
David Hsu ◽  
Gurston Nyquist ◽  
Howard Krein ◽  
Jurij Bilyk ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Free Flap ◽  
Meta Analysis ◽  
Fistula Formation ◽  
Wound Complications ◽  
Orbital Exenteration ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Orbital Wall

Objective Naso- or orbitocutaneous fistula (NOF) is a challenging complication of orbital exenteration, and it often requires surgical repair. We sought to identify the incidence and risk factors for NOF after orbital exenteration. Study Design Retrospective chart review, systematic review, meta-analysis. Setting Tertiary care center. Participants Patients undergoing free flap reconstruction following orbital exenteration. Records were reviewed for clinicopathologic data, operative details, and outcomes. Main Outcome Measures Univariate analysis was used to assess risk factors for incidence of postoperative NOF. PubMed and Cochrane databases were searched for published reports on NOF after orbital exenteration. Rates of fistula and odds ratios for predictive factors were compared in a meta-analysis. Results Total 7 of 77 patients (9.1%) developed NOF; fistula formation was associated with ethmoid sinus involvement (p < 0.05) and minor wound break down (p < 0.05). On meta-analysis, pooled rates of fistula formation were 5.8% for free flap patients and 12.5% for patients receiving no reconstruction. Conclusion Immediate postoperative wound complications and medial orbital wall resection increased the risk for NOF. On review and meta-analysis, reconstruction of orbital exenteration defects decreased the risk for fistula formation, but published series did not demonstrate a significant decrease in risk with free flaps compared with other methods of reconstruction.

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