Heterotopic Ossification of the Vascular Pedicle after Maxillofacial Reconstructive Surgery Using Fibular Free Flap: Introducing New Classification and Retrospective Analysis
Heterotopic ossification (HO) is one of the described phenomena after maxillofacial reconstructive surgery using fibular free flap (FFF) at the reception-site. The aim of this study was to determine the radiological incidence and form of HO along the fibular vascular pedicle as well as the rate of c...
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MDPI AG
2020-12-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/1/109 |
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| author | Michael Knitschke Kelly Siu Christina Bäcker Sameh Attia Hans-Peter Howaldt Sebastian Böttger |
| author_facet | Michael Knitschke Kelly Siu Christina Bäcker Sameh Attia Hans-Peter Howaldt Sebastian Böttger |
| author_sort | Michael Knitschke |
| collection | DOAJ |
| description | Heterotopic ossification (HO) is one of the described phenomena after maxillofacial reconstructive surgery using fibular free flap (FFF) at the reception-site. The aim of this study was to determine the radiological incidence and form of HO along the fibular vascular pedicle as well as the rate of clinical symptoms if present. CT-scans of 102 patients who underwent jaw reconstructive surgery by using FFF from January 2005 to December 2019 were evaluated concerning the presence of HO. Subsequently, the patient files were evaluated to identify the cases with clinical signs and complications related to the presence of HO. A radiological classification of four different HO types was developed. Out of 102 patients, 29 (28.43%) presented radiological findings of HO. Clinical symptoms were recorded in 10 cases (9.8%) (dysphagia (<i>n</i> = 5), trismus (<i>n</i> = 3), bony masses (<i>n</i> = 2)) and from these only five (4.9%) needed surgical removal of calcified structures. HO occurs significantly in younger patients (mean 52.3 year). In maxillary reconstructions, HO was radiologically visible six months earlier than after mandibular reconstruction. Furthermore, HO is observed after every third maxilla and every fourth mandible reconstruction. This study developed for the first time a classification of four distinct HO patterns. HO types 1 and 2 were mostly observed after mandible reconstruction and type 4 predominantly after maxilla reconstruction. |
| first_indexed | 2024-03-10T13:38:26Z |
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| id | doaj.art-1d6bb20a42ba4c8fb7059de90bf7b8fb |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T13:38:26Z |
| publishDate | 2020-12-01 |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-1d6bb20a42ba4c8fb7059de90bf7b8fb2023-11-21T03:11:31ZengMDPI AGJournal of Clinical Medicine2077-03832020-12-0110110910.3390/jcm10010109Heterotopic Ossification of the Vascular Pedicle after Maxillofacial Reconstructive Surgery Using Fibular Free Flap: Introducing New Classification and Retrospective AnalysisMichael Knitschke0Kelly Siu1Christina Bäcker2Sameh Attia3Hans-Peter Howaldt4Sebastian Böttger5Department of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, GermanyDepartment of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, GermanyDepartment of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, GermanyDepartment of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, GermanyDepartment of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, GermanyDepartment of Oral and Maxillofacial Surgery, Justus-Liebig-University, Klinikstrasse 33, 35392 Giessen, GermanyHeterotopic ossification (HO) is one of the described phenomena after maxillofacial reconstructive surgery using fibular free flap (FFF) at the reception-site. The aim of this study was to determine the radiological incidence and form of HO along the fibular vascular pedicle as well as the rate of clinical symptoms if present. CT-scans of 102 patients who underwent jaw reconstructive surgery by using FFF from January 2005 to December 2019 were evaluated concerning the presence of HO. Subsequently, the patient files were evaluated to identify the cases with clinical signs and complications related to the presence of HO. A radiological classification of four different HO types was developed. Out of 102 patients, 29 (28.43%) presented radiological findings of HO. Clinical symptoms were recorded in 10 cases (9.8%) (dysphagia (<i>n</i> = 5), trismus (<i>n</i> = 3), bony masses (<i>n</i> = 2)) and from these only five (4.9%) needed surgical removal of calcified structures. HO occurs significantly in younger patients (mean 52.3 year). In maxillary reconstructions, HO was radiologically visible six months earlier than after mandibular reconstruction. Furthermore, HO is observed after every third maxilla and every fourth mandible reconstruction. This study developed for the first time a classification of four distinct HO patterns. HO types 1 and 2 were mostly observed after mandible reconstruction and type 4 predominantly after maxilla reconstruction.https://www.mdpi.com/2077-0383/10/1/109reconstructive surgerymicrosurgeryfibular free flapFFFheterotopic ossification |
| spellingShingle | Michael Knitschke Kelly Siu Christina Bäcker Sameh Attia Hans-Peter Howaldt Sebastian Böttger Heterotopic Ossification of the Vascular Pedicle after Maxillofacial Reconstructive Surgery Using Fibular Free Flap: Introducing New Classification and Retrospective Analysis Journal of Clinical Medicine reconstructive surgery microsurgery fibular free flap FFF heterotopic ossification |
| title | Heterotopic Ossification of the Vascular Pedicle after Maxillofacial Reconstructive Surgery Using Fibular Free Flap: Introducing New Classification and Retrospective Analysis |
| title_full | Heterotopic Ossification of the Vascular Pedicle after Maxillofacial Reconstructive Surgery Using Fibular Free Flap: Introducing New Classification and Retrospective Analysis |
| title_fullStr | Heterotopic Ossification of the Vascular Pedicle after Maxillofacial Reconstructive Surgery Using Fibular Free Flap: Introducing New Classification and Retrospective Analysis |
| title_full_unstemmed | Heterotopic Ossification of the Vascular Pedicle after Maxillofacial Reconstructive Surgery Using Fibular Free Flap: Introducing New Classification and Retrospective Analysis |
| title_short | Heterotopic Ossification of the Vascular Pedicle after Maxillofacial Reconstructive Surgery Using Fibular Free Flap: Introducing New Classification and Retrospective Analysis |
| title_sort | heterotopic ossification of the vascular pedicle after maxillofacial reconstructive surgery using fibular free flap introducing new classification and retrospective analysis |
| topic | reconstructive surgery microsurgery fibular free flap FFF heterotopic ossification |
| url | https://www.mdpi.com/2077-0383/10/1/109 |
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