Sami P Moubayed 1 , Daniel A Barker 2 , Ali Razfar 2 , Vishad Nabili 2 , Keith E Blackwell 2 Show Affiliations »
Abstract
OBJECTIVE: To report our experience with mandibular resection and reconstruction using vascularized bone-containing free flaps without an elective tracheostomy. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral hospital center. SUBJECTS AND METHODS: Sixty-six patients undergoing mandibular reconstruction with vascularized bone-containing free flaps without an elective tracheostomy were identified between 1995 and 2013. We describe patient, tumor, and surgical factors and report perioperative outcomes in this population. RESULTS: Most patients underwent fibula free flap reconstruction (n = 61, 92.44%). The 4 most frequent indications for resection were osteoradionecrosis, parotid carcinoma, oral squamous cell carcinoma, and osteomyelitis. Bone defects ranging from 4.0 to 13.0 cm were reconstructed, and associated soft-tissue defects were reconstructed with skin paddle sizes ranging from 24.0 to 450.0 cm(2). There was only 1 patient with a bilateral central mandibular defect, and there were no tongue/pharyngeal soft-tissue defects or bilateral neck dissections. One case required emergent tracheostomy on postoperative day 1, and 2 more patients developed respiratory complications. There were no cases of perioperative death or flap failure. CONCLUSION: Mandibular free flap reconstruction is feasible without an elective tracheostomy in a subset of carefully selected patients without bilateral central mandibular defects, tongue/pharynx defects, or bilateral neck dissection. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.
OBJECTIVE: To report our experience with mandibular resection and reconstruction using vascularized bone-containing free flaps without an elective tracheostomy. STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral hospital center. SUBJECTS AND METHODS: Sixty-six patients undergoing mandibular reconstruction with vascularized bone-containing free flaps without an elective tracheostomy were identified between 1995 and 2013. We describe patient , tumor , and surgical factors and report perioperative outcomes in this population. RESULTS: Most patients underwent fibula free flap reconstruction (n = 61, 92.44%). The 4 most frequent indications for resection were osteoradionecrosis , parotid carcinoma , oral squamous cell carcinoma , and osteomyelitis . Bone defects ranging from 4.0 to 13.0 cm were reconstructed, and associated soft-tissue defects were reconstructed with skin paddle sizes ranging from 24.0 to 450.0 cm(2). There was only 1 patient with a bilateral central mandibular defect, and there were no tongue/pharyngeal soft-tissue defects or bilateral neck dissections. One case required emergent tracheostomy on postoperative day 1, and 2 more patients developed respiratory complications. There were no cases of perioperative death or flap failure . CONCLUSION: Mandibular free flap reconstruction is feasible without an elective tracheostomy in a subset of carefully selected patients without bilateral central mandibular defects, tongue/pharynx defects, or bilateral neck dissection. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.
Entities: Disease
Species
Keywords:
complications; free flap; mandibular reconstruction; tracheostomy
Mesh： See more »
Year: 2014
PMID： 25385807 DOI： 10.1177/0194599814556625
Source DB: PubMed Journal: Otolaryngol Head Neck Surg ISSN： 0194-5998 Impact factor: 3.497