FIBULA OSTEOSEPTOCUTANEOUS FLAP FOR RECONSTRUCTION OF OSTEORADIONECROSIS OF THE MANDIBLE

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.