Document Detail


The role of the osteocutaneous radial forearm free flap in the treatment of mandibular osteoradionecrosis.
MedLine Citation:
PMID:  16025057     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To evaluate the role of the osteocutaneous radial forearm free flap (OCRFFF) in the treatment of mandibular osteoradionecrosis (ORN). STUDY DESIGN AND SETTING: Retrospective case review of patients who underwent OCRFFF oromandibular reconstruction after resection of nonviable tissue at an academic tertiary care center because of ORN. Patients with reconstructions other than OCRFFF were excluded from this study. RESULTS: Nine patients underwent a composite oromandibular resection for ORN with a reconstruction using an OCRFFF between April 1998 and February 2003. All patients had failed previous less aggressive surgical and medical management of the ORN. Mean follow-up was 36 months (range, 14-67 months). There were no flap failures or significant immediate postoperative or long-term complications observed. All patients had successful restoration of mandibular integrity and continuity, with 100% success rate of stabilization of ORN. All patients were able to tolerate PO diet, with only one third having to supplement their diet with gastrostomy feedings, compared with 89% gastrostomy dependence preoperatively. CONCLUSIONS: Primary or adjuvant radiotherapy for head and neck malignancies can result in ORN of the mandible. This difficult problem often requires surgical intervention. In our experience, the OCRFFF can be successfully used for oromandibular reconstruction, even in the setting of the heavily radiated tissue with excellent postoperative outcomes. SIGNIFICANCE: This is the first study that demonstrates the efficacy of the OCRFFF as a treatment of mandibular ORN.
Authors:
Oleg N Militsakh; Derrick I Wallace; J David Kriet; Terance T Tsue; Douglas A Girod
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery     Volume:  133     ISSN:  0194-5998     ISO Abbreviation:  Otolaryngol Head Neck Surg     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-18     Completed Date:  2005-09-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8508176     Medline TA:  Otolaryngol Head Neck Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  80-3     Citation Subset:  IM    
Affiliation:
Department of Otorhinolaryngology-Head and Neck Surgery, University of Kansas School of Medicine, Kansas City 66160, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Carcinoma, Squamous Cell / radiotherapy*
Female
Forearm / surgery
Graft Survival
Head and Neck Neoplasms / radiotherapy*
Humans
Male
Mandibular Diseases / etiology,  surgery*
Melanoma / radiotherapy
Middle Aged
Osteoradionecrosis / etiology,  surgery*
Radiotherapy / adverse effects
Radius / transplantation
Retrospective Studies
Surgical Flaps*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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