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Titolo:
Mandibular reconstruction using microvascular free flaps: A statistical analysis of 178 cases
Autore:
Takushima, A; Harii, K; Asato, H; Nakatsuka, T; Kimata, Y;
Indirizzi:
Univ Tokyo, Grad Sch Med, Dept Plast & Reconstruct Surg, Bunkyo Ku, Tokyo 1138655, Japan Univ Tokyo Tokyo Japan 1138655 uct Surg, Bunkyo Ku, Tokyo 1138655, Japan Natl Canc Ctr Hosp, Div Plast & Reconstruct Surg, Chiba, Japan Natl Canc Ctr Hosp Chiba Japan v Plast & Reconstruct Surg, Chiba, Japan
Titolo Testata:
PLASTIC AND RECONSTRUCTIVE SURGERY
fascicolo: 6, volume: 108, anno: 2001,
pagine: 1555 - 1563
SICI:
0032-1052(200111)108:6<1555:MRUMFF>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
VASCULARIZED BONE FLAPS; FIBULA FREE-FLAP; RADIAL FOREARM; OROMANDIBULAR RECONSTRUCTION; ILIAC CREST; 10-YEAR EXPERIENCE; SCAPULAR FLAP; DEFECTS; GRAFTS; PLATE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
50
Recensione:
Indirizzi per estratti:
Indirizzo: Takushima, A Univ Tokyo, Grad Sch Med, Dept Plast & Reconstruct Surg, Bunkyo Ku, 7-3-1 Hongo, Tokyo 1138655, Japan Univ Tokyo 7-3-1 Hongo Tokyo Japan 1138655 yo 1138655, Japan
Citazione:
A. Takushima et al., "Mandibular reconstruction using microvascular free flaps: A statistical analysis of 178 cases", PLAS R SURG, 108(6), 2001, pp. 1555-1563

Abstract

For this article, 178 consecutive cases of mandibular reconstruction usingmicrovascular free flaps and performed from 1979 to 1997 were studied. Thepurpose of this report is to compare flap success rates, complications, and aesthetic and functional results. The ages of the 131 men and 47 women ranged from 13 to 85 years, with an average of 55 years. Donor sites includedthe rib (11 cases), radius (one case), ilium (36 cases), scapula (51 cases), fibula (34 cases), and soft-tissue flaps with implant (45 cases). Complications included total flap necrosis, partial flap necrosis, major fistula formation, and minor fistula formation. The rate of total flap necrosis involving the ilium and fibula was significantly higher than that of all othermaterials combined (P < 0.05). The overall rate of implant plate removal, which resulted from the exposure or fracture of the plate, was 35.6 percent(16 of 45 cases). Each mandibular defect was classified by the extent of the bony defect andby the extent of the soft-tissue defect. The extent of the mandibular bonydefect was classified according to the HCL method of Jewer et al. The extent of the soft-tissue defect was classified into four groups: none, skin, mucosal, and through-and-through. According to these classifications, functional and aesthetic assessments of deglutition and contour were performed on115 subjects, and speech was evaluated in 110. To evaluate the postoperative results, points were assigned to each assessment of deglutition, speech,and mandibular contour. Statistical analysis between pairs of bone-defect groups revealed that there was no significant difference in each category. Regarding deglutition, statistical analysis between pairs of soft-tissue-defect groups revealed there were significant differences (P < 0.05) between the none and the mucosal groups and also between the none and the through-and-through groups. Regarding speech, there was a significant difference (p < 0.05) between the none and the through-and-through groups. Regarding ontour, there were significant differences (p < 0.01) between the none and the through-and-through groups and between the mucosal and the through-and-through groups. The points given for each function, depending on the reconstruction material, revealed that there was no significant difference between pairs of material groups. From this prospective study, the authors have developed an algorithm for oromandibular reconstruction. When the bony defect is lateral, the ilium, fibula, or scapula should be chosen as the donor site, depending on the extent of the soft-tissue defect. When the bony defect is anterior, the fibula is always the best choice. When the soft-tissue defect is extensive or through-and-th rough with an anterior bony defect, the fibula should be used with other soft-tissue flaps.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/11/20 alle ore 03:10:14