Plastic and reconstructive surgery · 2025
Reconstructing Segmental Mandibular Defects: A Single-Center, 21-Year Experience with 413 Fibula Free Flaps.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Allen Robert J, Zhang Kevin K, Cohen Zack, Shahzad Farooq, Nelson Jonas A, McCarthy Colleen M, Patel Snehal G, Boyle Jay O, Shah Jatin P, Disa Joseph J, Cordeiro Peter G, Mehrara Babak J, Matros Evan
Аннотация
BACKGROUND: The fibula free flap (FFF) is a common choice for mandibular reconstruction after oncologic resection. Advances in technology and surgical technique have changed the workflow of FFF-based mandible reconstruction. This study characterizes an institutional experience with these changes and their impact on patient outcomes.
METHODS: A 21-year retrospective review was performed of patients who underwent segmental mandibulectomy with FFF-based reconstruction.
RESULTS A TOTAL OF: 401 patients underwent reconstruction with 413 free flaps, with a median follow-up period of 2.9 years. Over the study period, there was an upward trend in case volume, with an average procedure length of 675.6 ± 132.5 minutes. Mini-plates ( n = 340 [82.3%]) were most commonly used for flap fixation initially, but reconstruction bars ( n = 73 [17.7%]) later became the preferred fixation method. A total of 168 (40.7%) patients had surgical planning with computer-aided design and manufacturing. A total of 98 (23.7%) patients underwent immediate dental implant placement. As computer-aided design and manufacturing and immediate dental implant placement became more prevalent during the study period, dental rehabilitation rates increased. A total of 226 (54.7%) patients experienced a complication at the recipient site, 122 (29.5%) of which required operative management; the rate of complications showed no discernable trend during the study period. The overall flap success rate of this cohort was 97.8%, with an all-cause mortality rate of 43.6%.
CONCLUSIONS: This study presents an institutional series of FFF-based mandible reconstruction in the 21st century. Advances in surgical technique and technology have improved operative workflow and patient outcomes; however, postoncologic mandible reconstruction remains a highly morbid procedure.
METHODS: A 21-year retrospective review was performed of patients who underwent segmental mandibulectomy with FFF-based reconstruction.
RESULTS A TOTAL OF: 401 patients underwent reconstruction with 413 free flaps, with a median follow-up period of 2.9 years. Over the study period, there was an upward trend in case volume, with an average procedure length of 675.6 ± 132.5 minutes. Mini-plates ( n = 340 [82.3%]) were most commonly used for flap fixation initially, but reconstruction bars ( n = 73 [17.7%]) later became the preferred fixation method. A total of 168 (40.7%) patients had surgical planning with computer-aided design and manufacturing. A total of 98 (23.7%) patients underwent immediate dental implant placement. As computer-aided design and manufacturing and immediate dental implant placement became more prevalent during the study period, dental rehabilitation rates increased. A total of 226 (54.7%) patients experienced a complication at the recipient site, 122 (29.5%) of which required operative management; the rate of complications showed no discernable trend during the study period. The overall flap success rate of this cohort was 97.8%, with an all-cause mortality rate of 43.6%.
CONCLUSIONS: This study presents an institutional series of FFF-based mandible reconstruction in the 21st century. Advances in surgical technique and technology have improved operative workflow and patient outcomes; however, postoncologic mandible reconstruction remains a highly morbid procedure.