PURPOSE: To evaluate the success rate and complications of segmental mandibular reconstructions with autogenous nonvascularized iliac crest bone grafts, and to refine treatment strategies. PATIENTS AND METHODS: Seventy-four patients with segmental mandibular defects were included. Malignant lesion, immediate reconstruction, smoking habit, radiotherapy, site of the defect, surgical approach, and method of graft fixation were analyzed as factors of influence on success. Success was defined as maintenance of bone continuity and stability, and absence of infection 1 year after reconstruction upon clinical and radiographic examination. Complications were divided into recipient and donor-site complications and classified as minor or major. The reconstruction was considered functionally complete if prosthetic rehabilitation was accomplished or if there was a sufficient remaining dentition for mastication. RESULTS: In 56 (76%) patients, the initial reconstruction was successful. Multivariate analyses showed that symphyseal involvement (SI) and intraoral approach (IA) were significantly associated with failure (P(SI) = .022, P(IA) = .038) and major recipient-site complications (P(SI) = .022, P(IA) = .038). Thirty-two (43%) patients showed complications in the first postoperative year: 27 recipient-site complications and 6 donor-site complications. Nineteen (70%) recipient-site complications were classified as major. The reconstruction was functionally complete in 48 (86%) of the 56 patients with a successful initial reconstruction. CONCLUSIONS: Nonvascularized iliac crest bone grafts for segmental reconstruction of the mandible is the method of choice on the condition that the defect is truly lateral and only an extraoral approach is used. In these cases, microvascular tissue transfer is not necessary.
PURPOSE: To evaluate the success rate and complications of segmental mandibular reconstructions with autogenous nonvascularized iliac crest bone grafts, and to refine treatment strategies. PATIENTS AND METHODS: Seventy-four patients with segmental mandibular defects were included. Malignant lesion, immediate reconstruction, smoking habit, radiotherapy, site of the defect, surgical approach, and method of graft fixation were analyzed as factors of influence on success. Success was defined as maintenance of bone continuity and stability, and absence of infection 1 year after reconstruction upon clinical and radiographic examination. Complications were divided into recipient and donor-site complications and classified as minor or major. The reconstruction was considered functionally complete if prosthetic rehabilitation was accomplished or if there was a sufficient remaining dentition for mastication. RESULTS: In 56 (76%) patients, the initial reconstruction was successful. Multivariate analyses showed that symphyseal involvement (SI) and intraoral approach (IA) were significantly associated with failure (P(SI) = .022, P(IA) = .038) and major recipient-site complications (P(SI) = .022, P(IA) = .038). Thirty-two (43%) patients showed complications in the first postoperative year: 27 recipient-site complications and 6 donor-site complications. Nineteen (70%) recipient-site complications were classified as major. The reconstruction was functionally complete in 48 (86%) of the 56 patients with a successful initial reconstruction. CONCLUSIONS: Nonvascularized iliac crest bone grafts for segmental reconstruction of the mandible is the method of choice on the condition that the defect is truly lateral and only an extraoral approach is used. In these cases, microvascular tissue transfer is not necessary.
Authors: Nichole R Dean; Mark K Wax; Frank W Virgin; J Scott Magnuson; William R Carroll; Eben L Rosenthal Journal: Otolaryngol Head Neck Surg Date: 2011-12-12 Impact factor: 3.497
Authors: Kevin M Urlaub; Russell E Ettinger; Noah S Nelson; Jessie M Hoxie; Alicia E Snider; Joseph E Perosky; Yekaterina Polyatskaya; Alexis Donneys; Steven R Buchman Journal: J Craniofac Surg Date: 2019 Mar/Apr Impact factor: 1.046
Authors: James D Kretlow; Meng Shi; Simon Young; Patrick P Spicer; Nagi Demian; John A Jansen; Mark E Wong; F Kurtis Kasper; Antonios G Mikos Journal: Tissue Eng Part C Methods Date: 2010-06-04 Impact factor: 3.056
Authors: Eric M Genden; Alfio Ferlito; Carl E Silver; Robert P Takes; Carlos Suárez; Randall P Owen; Missak Haigentz; Sandro J Stoeckli; Ashok R Shaha; Alexander D Rapidis; Juan Pablo Rodrigo; Alessandra Rinaldo Journal: Eur Arch Otorhinolaryngol Date: 2010-02-13 Impact factor: 2.503
Authors: Nicolas E Sierra; Paula Diaz-Gallardo; Jorge Knörr; Vasco Mascarenhas; Eloy García-Diez; Montserrat Munill-Ferrer; Maria S Bescós-Atín; Francisco Soldado Journal: Craniomaxillofac Trauma Reconstr Date: 2017-01-05