Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case–control study

Abstract Background Free osteocutaneous fibula flap (FFF) is currently considered the best option for segmental mandibular reconstruction; however, there are only a few reports comparing secondary with primary reconstructions using FFF. This study aimed to evaluate the safety and efficacy of seconda...

Full description

Bibliographic Details
Main Authors: Sho Yamakawa, Kenji Hayashida
Format: Article
Language:English
Published: BMC 2021-04-01
Series:BMC Surgery
Subjects:
Online Access:https://doi.org/10.1186/s12893-021-01194-3
_version_ 1831767691284709376
author Sho Yamakawa
Kenji Hayashida
author_facet Sho Yamakawa
Kenji Hayashida
author_sort Sho Yamakawa
collection DOAJ
description Abstract Background Free osteocutaneous fibula flap (FFF) is currently considered the best option for segmental mandibular reconstruction; however, there are only a few reports comparing secondary with primary reconstructions using FFF. This study aimed to evaluate the safety and efficacy of secondary mandibular reconstruction using FFF when compared with primary mandibular reconstruction. Methods From October 2018 to February 2020, patients who underwent mandibular reconstruction using FFF after segmental mandibulectomy were retrospectively reviewed. The size and location of the mandibular defect, the segment length and number of osteotomies in the fibula, types of the mandibular plating system, kinds and laterality of the recipient vessels were recorded from the surgical notes. Flap survival, duration of nasogastric tube use, and implant installation after reconstruction were recorded as postoperative evaluation indices. Results Twelve patients underwent mandibular reconstruction using FFF during the study period. There were no significant differences in demographic characteristics other than body mass index between the primary (n = 8) and secondary (n = 4) reconstruction groups. No significant differences were observed in the size and location of defects, the segment length and number of osteotomies in the fibula, and the types of mandibular plating system. There was no significant difference in the kinds of recipient vessels; however, the laterality of recipient vessels was ipsilateral in all cases of primary reconstructions and contralateral in all cases of secondary reconstructions. Three out of eight patients with primary FFF reconstruction developed partial flap necrosis. Four patients in the secondary FFF reconstruction group achieved complete flap survival. The duration of use of the nasogastric tube and implant installation after reconstruction was comparable between the two groups. Conclusion Safe and effective secondary mandibular reconstruction can be performed in this clinical case study using FFF.
first_indexed 2024-12-22T06:46:56Z
format Article
id doaj.art-23089124411d4548a6369c5d40092c1a
institution Directory Open Access Journal
issn 1471-2482
language English
last_indexed 2024-12-22T06:46:56Z
publishDate 2021-04-01
publisher BMC
record_format Article
series BMC Surgery
spelling doaj.art-23089124411d4548a6369c5d40092c1a2022-12-21T18:35:15ZengBMCBMC Surgery1471-24822021-04-012111910.1186/s12893-021-01194-3Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case–control studySho Yamakawa0Kenji Hayashida1Division of Plastic and Reconstructive Surgery, Faculty of Medicine Shimane UniversityDivision of Plastic and Reconstructive Surgery, Faculty of Medicine Shimane UniversityAbstract Background Free osteocutaneous fibula flap (FFF) is currently considered the best option for segmental mandibular reconstruction; however, there are only a few reports comparing secondary with primary reconstructions using FFF. This study aimed to evaluate the safety and efficacy of secondary mandibular reconstruction using FFF when compared with primary mandibular reconstruction. Methods From October 2018 to February 2020, patients who underwent mandibular reconstruction using FFF after segmental mandibulectomy were retrospectively reviewed. The size and location of the mandibular defect, the segment length and number of osteotomies in the fibula, types of the mandibular plating system, kinds and laterality of the recipient vessels were recorded from the surgical notes. Flap survival, duration of nasogastric tube use, and implant installation after reconstruction were recorded as postoperative evaluation indices. Results Twelve patients underwent mandibular reconstruction using FFF during the study period. There were no significant differences in demographic characteristics other than body mass index between the primary (n = 8) and secondary (n = 4) reconstruction groups. No significant differences were observed in the size and location of defects, the segment length and number of osteotomies in the fibula, and the types of mandibular plating system. There was no significant difference in the kinds of recipient vessels; however, the laterality of recipient vessels was ipsilateral in all cases of primary reconstructions and contralateral in all cases of secondary reconstructions. Three out of eight patients with primary FFF reconstruction developed partial flap necrosis. Four patients in the secondary FFF reconstruction group achieved complete flap survival. The duration of use of the nasogastric tube and implant installation after reconstruction was comparable between the two groups. Conclusion Safe and effective secondary mandibular reconstruction can be performed in this clinical case study using FFF.https://doi.org/10.1186/s12893-021-01194-3Free osteocutaneous fibula flapSegmental mandibular resectionSecondary mandibular reconstruction
spellingShingle Sho Yamakawa
Kenji Hayashida
Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case–control study
BMC Surgery
Free osteocutaneous fibula flap
Segmental mandibular resection
Secondary mandibular reconstruction
title Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case–control study
title_full Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case–control study
title_fullStr Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case–control study
title_full_unstemmed Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case–control study
title_short Safety and efficacy of secondary mandibular reconstruction using a free osteo-cutaneous fibula flap after segmental mandibular resection: a retrospective case–control study
title_sort safety and efficacy of secondary mandibular reconstruction using a free osteo cutaneous fibula flap after segmental mandibular resection a retrospective case control study
topic Free osteocutaneous fibula flap
Segmental mandibular resection
Secondary mandibular reconstruction
url https://doi.org/10.1186/s12893-021-01194-3
work_keys_str_mv AT shoyamakawa safetyandefficacyofsecondarymandibularreconstructionusingafreeosteocutaneousfibulaflapaftersegmentalmandibularresectionaretrospectivecasecontrolstudy
AT kenjihayashida safetyandefficacyofsecondarymandibularreconstructionusingafreeosteocutaneousfibulaflapaftersegmentalmandibularresectionaretrospectivecasecontrolstudy