Lucas M Ritschl1, Thomas Mücke2, Diandra Hart3, Tobias Unterhuber3, Victoria Kehl4, Klaus-Dietrich Wolff3, Andreas M Fichter3. 1. Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany. lucas.ritschl@tum.de. 2. Department of Oral and Maxillofacial Surgery, Malteser Kliniken Rhein-Ruhr, Kurfürstenstraße 69, 47829, Krefeld-Uerdingen, Germany. 3. Department of Oral and Maxillofacial Surgery, School of Medicine, Technical University of Munich, Klinikum rechts der Isar, Ismaninger Straße 22, 81675, Munich, Germany. 4. School of Medicine, Institute of Medical Informatics, Statistics and Epidemiology, Technical University of Munich, Grillparzerstraße 18, 81675, Munich, Germany.
Abstract
OBJECTIVES: The purpose of this study was to evaluate the incidence of complications following mandibular reconstruction and to analyse possible contributing factors. MATERIALS AND METHODS: Clinical data and computed tomography scans of all patients who needed a mandibular reconstruction with a reconstruction plate, free fibula flap (FFF) or iliac crest (DCIA) flap between August 2010 and August 2015 were retrospectively analysed. RESULTS: One hundred and ninety patients were enrolled, encompassing 77 reconstructions with reconstruction plate, 89 reconstructions with FFF and 24 reconstructions with DCIA flaps. Cutaneous perforation was most frequently detected in the plate subgroup within the early interval and overall (each p = 0.004). Low body mass index (BMI) and total radiation dosage were the most relevant risk factors for the development of analysed complications. CONCLUSIONS: Microvascular bone flaps have overall less skin perforation than reconstruction plates. BMI and expected total radiation dosage have to be respected in choice of reconstructive technique. CLINICAL RELEVANCE: A treatment algorithm for mandibular reconstructions on the basis of our results is presented.
OBJECTIVES: The purpose of this study was to evaluate the incidence of complications following mandibular reconstruction and to analyse possible contributing factors. MATERIALS AND METHODS: Clinical data and computed tomography scans of all patients who needed a mandibular reconstruction with a reconstruction plate, free fibula flap (FFF) or iliac crest (DCIA) flap between August 2010 and August 2015 were retrospectively analysed. RESULTS: One hundred and ninety patients were enrolled, encompassing 77 reconstructions with reconstruction plate, 89 reconstructions with FFF and 24 reconstructions with DCIA flaps. Cutaneous perforation was most frequently detected in the plate subgroup within the early interval and overall (each p = 0.004). Low body mass index (BMI) and total radiation dosage were the most relevant risk factors for the development of analysed complications. CONCLUSIONS: Microvascular bone flaps have overall less skin perforation than reconstruction plates. BMI and expected total radiation dosage have to be respected in choice of reconstructive technique. CLINICAL RELEVANCE: A treatment algorithm for mandibular reconstructions on the basis of our results is presented.
Authors: Michael R Markiewicz; R Bryan Bell; Tuan G Bui; Eric J Dierks; Ramon Ruiz; Savannah Gelesko; Phillip Pirgousis; Rui Fernandes Journal: Microsurgery Date: 2015-10-09 Impact factor: 2.425
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Authors: J Weitz; F J M Bauer; A Hapfelmeier; N H Rohleder; K-D Wolff; M R Kesting Journal: Br J Oral Maxillofac Surg Date: 2016-02-18 Impact factor: 1.651
Authors: Jan-Willem G H Wetzels; Matthias A W Merkx; Anton F J de Haan; Ron Koole; Caroline M Speksnijder Journal: Head Neck Date: 2014-01-30 Impact factor: 3.147