Sean Hashemi1, Masafumi Oda2, Keita Onoue2, Krystyne Basa1, Samuel J Rubin1, Osamu Sakai2, Andrew Salama3, Waleed H Ezzat4. 1. Division of Facial Plastic and Reconstructive Surgery, Boston Medical Center, Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA. 2. Department of Radiology, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. 3. Department of Oral & Maxillofacial Surgery, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA. 4. Division of Facial Plastic and Reconstructive Surgery, Boston Medical Center, Department of Otolaryngology-Head and Neck Surgery, Boston University School of Medicine, Boston, MA, USA. Electronic address: ezzatmd@gmail.com.
Abstract
OBJECTIVE: Fibula free tissue transfer is a common and reliable method for mandibular reconstruction. Functional outcomes from this procedure are dependent on the successful union of the osseous segments postoperatively. This study was conducted to define the maximum gap-size criteria for osseous union to occur at osteotomy sites in fibula free flap reconstruction of the mandible. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care academic center. SUBJECTS AND METHODS: A retrospective chart review of computed tomography and medical records was conducted on patients who underwent fibula free flap surgery and had imaging of the mandible at <3 months and >6 months after surgery. Distances between osteotomies were measured and evaluated for interval healing. Secondary data included subject age, sex, smoking status, diabetes, number of osteotomies, complications, and adjuvant therapy. RESULTS: Thirty-eight osteotomy sites were analyzed from thirteen subjects and a total of 190 measurements were made. The mean gap size at the first scan that demonstrated union by the second scan interval was 1.31 mm and mean gap size demonstrating non-union was 2.55 mm (p < 0.01). Complication rate, number of osetotomies, adjuvant therapy, or medical co-morbidities did not significantly affect rates of union. CONCLUSIONS: In this study, osseous union was achieved with a mean osteotomy gap size of 1.31 mm. The data suggests that distances between ossesous segments >2 .55mm have a higher risk of non-union. We believe the information from this study will help augment current and future techniques in the field of mandible reconstruction. Published by Elsevier Inc.
OBJECTIVE: Fibula free tissue transfer is a common and reliable method for mandibular reconstruction. Functional outcomes from this procedure are dependent on the successful union of the osseous segments postoperatively. This study was conducted to define the maximum gap-size criteria for osseous union to occur at osteotomy sites in fibula free flap reconstruction of the mandible. STUDY DESIGN: Retrospective chart review. SETTING: Tertiary care academic center. SUBJECTS AND METHODS: A retrospective chart review of computed tomography and medical records was conducted on patients who underwent fibula free flap surgery and had imaging of the mandible at <3 months and >6 months after surgery. Distances between osteotomies were measured and evaluated for interval healing. Secondary data included subject age, sex, smoking status, diabetes, number of osteotomies, complications, and adjuvant therapy. RESULTS: Thirty-eight osteotomy sites were analyzed from thirteen subjects and a total of 190 measurements were made. The mean gap size at the first scan that demonstrated union by the second scan interval was 1.31 mm and mean gap size demonstrating non-union was 2.55 mm (p < 0.01). Complication rate, number of osetotomies, adjuvant therapy, or medical co-morbidities did not significantly affect rates of union. CONCLUSIONS: In this study, osseous union was achieved with a mean osteotomy gap size of 1.31 mm. The data suggests that distances between ossesous segments >2 .55mm have a higher risk of non-union. We believe the information from this study will help augment current and future techniques in the field of mandible reconstruction. Published by Elsevier Inc.
Authors: Claudius Steffen; Heilwig Fischer; Marius Sauerbrey; Thelma Heintzelmann; Jan Oliver Voss; Steffen Koerdt; Sara Checa; Kilian Kreutzer; Max Heiland; Carsten Rendenbach Journal: Dentomaxillofac Radiol Date: 2022-08-10 Impact factor: 3.525
Authors: Akina Tamaki; Shruthi Sethuraman; Lucy Shi; Songzhu Zhao; Keith C Carver; Angel Hatef; Michael Luttrull; Nolan B Seim; Stephen Y Kang; Enver Ozer; Amit Agrawal; Matthew O Old Journal: OTO Open Date: 2022-01-12