Carlos Navarro Cuellar1, Santiago José Ochandiano Caicoya2, Julio Jesús Acero Sanz3, Ignacio Navarro Cuellar4, Cristina Maza Muela2, Carlos Navarro Vila5. 1. Associate Professor, Maxillofacial Surgery, Complutense University Medical School, Madrid, Spain; Staff Member, Oral and Maxillofacial Department, Gregorio Marañón General Hospital, Madrid, Spain. Electronic address: cnavarrocuellar@gmail.com. 2. Staff Member, Oral and Maxillofacial Department, Gregorio Marañón General Hospital, Madrid, Spain. 3. Head, Oral and Maxillofacial Department, Ramón y Cajal Hospital, Madrid, Spain. 4. Staff Member, Oral and Maxillofacial Department, Virgen de la Salud Hospital, Toledo, Spain. 5. Full Professor, Maxillofacial Surgery, Complutense University Medical School, Madrid, Spain; Head and Chair, Oral and Maxillofacial Department, Gregorio Marañón General Hospital, Madrid, Spain.
Abstract
PURPOSE: Oncologic patients undergoing segmental mandibulectomy with soft tissue resection develop several esthetic and functional sequelae; therefore, the defect must be reconstructed immediately. The iliac crest flap is the only flap that allows reconstruction of the previous dimensions of the mandible. However, the excessive soft tissue of this flap prevents optimal reconstruction of intraoral soft tissue defects. MATERIALS AND METHODS: This report describes a reconstructive technique used in 12 patients who underwent segmental mandibulectomy because of soft tissue defects resulting from tumor resection. The technique involves reconstruction of the mandible using an iliac crest flap combined with a nasolabial flap to enable subsequent reconstruction of the intraoral soft tissue and immediate placement of osseointegrated implants. RESULTS: The osseointegration success rate was 95.2% with a failure rate of 4.8%. Failure particularly affected the irradiated patients. Excellent functional and aesthetic results were obtained with the iliac crest free flap, nasolabial flap and osseointegrated dental implants. CONCLUSIONS: This technique has several advantages. On the one hand, it enables reconstruction of the original dimensions of the mandible, thus allowing immediate placement of implants in an ideal position for subsequent rehabilitation with a dental prosthesis. On the other hand, the nasolabial flap provides a thin layer of tissue that can be used to reconstruct the anatomy of the oromandibular soft tissue.
PURPOSE: Oncologic patients undergoing segmental mandibulectomy with soft tissue resection develop several esthetic and functional sequelae; therefore, the defect must be reconstructed immediately. The iliac crest flap is the only flap that allows reconstruction of the previous dimensions of the mandible. However, the excessive soft tissue of this flap prevents optimal reconstruction of intraoral soft tissue defects. MATERIALS AND METHODS: This report describes a reconstructive technique used in 12 patients who underwent segmental mandibulectomy because of soft tissue defects resulting from tumor resection. The technique involves reconstruction of the mandible using an iliac crest flap combined with a nasolabial flap to enable subsequent reconstruction of the intraoral soft tissue and immediate placement of osseointegrated implants. RESULTS: The osseointegration success rate was 95.2% with a failure rate of 4.8%. Failure particularly affected the irradiated patients. Excellent functional and aesthetic results were obtained with the iliac crest free flap, nasolabial flap and osseointegrated dental implants. CONCLUSIONS: This technique has several advantages. On the one hand, it enables reconstruction of the original dimensions of the mandible, thus allowing immediate placement of implants in an ideal position for subsequent rehabilitation with a dental prosthesis. On the other hand, the nasolabial flap provides a thin layer of tissue that can be used to reconstruct the anatomy of the oromandibular soft tissue.
Authors: Paweł Turek; Paweł Pakla; Grzegorz Budzik; Bogumił Lewandowski; Łukasz Przeszłowski; Tomasz Dziubek; Sławomir Wolski; Jan Frańczak Journal: J Clin Med Date: 2021-11-25 Impact factor: 4.241