PURPOSE OF REVIEW: This article reviews literature pertaining to advances in the reconstruction of segmental mandibular defects in the context of an established standard of care, microvascular transfer of free osteocutaneous flaps. RECENT FINDINGS: Most literature reiterates established reconstructive techniques. Exceptions include the use of computer-assisted modeling to preoperatively design the excision of both the mandible and fibula segments and to produce a template for contouring the neomandible, the design of new flaps, distraction osteogenesis and techniques for dealing with osteonecrosis. SUMMARY: The microvascular transfer of free osteocutaneous flaps remains the standard of care, with the fibula flap the clear favorite. Review of the evolution of this flap for segmental mandibular reconstruction provides the bulk of the literature. Improvement on this standard of practice continues to be elusive, in large part because of the effects of associated radiation. Tissue engineering holds promise but no current practical application is available.
PURPOSE OF REVIEW: This article reviews literature pertaining to advances in the reconstruction of segmental mandibular defects in the context of an established standard of care, microvascular transfer of free osteocutaneous flaps. RECENT FINDINGS: Most literature reiterates established reconstructive techniques. Exceptions include the use of computer-assisted modeling to preoperatively design the excision of both the mandible and fibula segments and to produce a template for contouring the neomandible, the design of new flaps, distraction osteogenesis and techniques for dealing with osteonecrosis. SUMMARY: The microvascular transfer of free osteocutaneous flaps remains the standard of care, with the fibula flap the clear favorite. Review of the evolution of this flap for segmental mandibular reconstruction provides the bulk of the literature. Improvement on this standard of practice continues to be elusive, in large part because of the effects of associated radiation. Tissue engineering holds promise but no current practical application is available.
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: Alexander M Tatara; James D Kretlow; Patrick P Spicer; Steven Lu; Johnny Lam; Wei Liu; Yilin Cao; Guangpeng Liu; John D Jackson; James J Yoo; Anthony Atala; Jeroen J J P van den Beucken; John A Jansen; F Kurtis Kasper; Tang Ho; Nagi Demian; Michael John Miller; Mark E Wong; Antonios G Mikos Journal: Tissue Eng Part A Date: 2015-03-03 Impact factor: 3.845