E. Santamaria et al., FIBULA OSTEOSEPTOCUTANEOUS FLAP FOR RECONSTRUCTION OF OSTEORADIONECROSIS OF THE MANDIBLE, Plastic and reconstructive surgery, 101(4), 1998, pp. 921-929
Osteoradionecrosis of the mandible poses formidable problems for treat
ment. In the last 6 years, the fibula osteoseptocutaneous free flap wa
s used in 12 cases to replace mandibles with radionecrotic damage. The
presence of a pathologic fracture, exposed necrotic bone, or a persis
tent fistula not responding to conservative treatment were the indicat
ions for such a radical approach. Mandible defects after resection wer
e around 8.0 cm long, and in all cases intraoral mucosa, skin, or both
were included with the bone excision. All vascularized fibula osteose
ptocutaneous flaps transplanted were successful with good primary bone
healing. Adequate facial symmetry and improvement in oral function wa
s achieved. No evidence of osteoradionecrosis recurrence was observed
after a mean follow-up period of 3 years and 9 months. The advantages
of using the fibula osteoseptocutaneous flap for mandible reconstructi
on are numerous, and good aesthetic and functional results can be obta
ined when it is used for reconstruction after radical excision of oste
oradionecrotic lesions.