C. Ioannides et al., SURGICAL-MANAGEMENT OF THE OSTEORADIONECROTIC MANDIBLE WITH FREE VASCULARIZED COMPOSITE FLAPS, Journal of cranio-maxillo-facial surgery, 22(6), 1994, pp. 330-334
Osteoradionecrosis (ORN) of the mandible is a serious sequel to radiot
herapy administered for malignant neoplasms of the head and neck. In a
retrospective/prospective study, 28 patients with mandibular defects
due to ORN were reviewed. Monocortical and bicortical defects as well
as pathological fractures were reconstructed by means of a free serrat
us anterior/rib (n = 8) or a vascularised iliac crest flap (n = 25). A
ll the former survived; a pathological fracture, however, occurred pos
toperatively in 2 of the patients (25%). Five iliac crests were lost (
20%). The remaining bone struts healed well. The donor site morbidity
was very low. Clinical and radiological longterm follow-up showed that
a very acceptable functional and cosmetic result was achieved in all
cases. Progress of ORN was prevented in ca. 90% of all patients. The r
adiological follow-up was facilitated with the use of high-resolution
CT-scans.