Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study

Abstract

The objective of this study was to analyze the outcomes of the free vascularized fibular flap in the reconstruction of mandibular defects, and to assess the oral health impact profile of these patients before surgery and after oral rehabilitation. Patients requiring reconstruction of defects greater than 6 cm were selected for this study. The defect size and type, the size of the required skin paddle, the need for second flaps, the intraoperative complications, and the type of closure were documented. Patients were evaluated postoperatively for function, aesthetics, and donor- or reconstruction-site complications. The validated oral health impact profile (OHIP-14) questionnaires were filled before and after surgery and after dental rehabilitation. This study included 11 cases of squamous-cell carcinomas, 2 cases of malignant nerve sheath tumors, and 1 case each of malignant melanoma, ameloblastoma, giant-cell tumor, osteosarcoma, and chondrosarcoma. The analysis revealed a significant association (p = 0.030) of gender with free vascular flap complications, while no significant association (p > 0.05) was found when donor- and recipient- site complications, as well as the type of resection (Brown’s classification), were compared with free vascular flaps. Moreover, the total OHIP-14 scores for patients before surgery, after surgery, and after dental rehabilitation were 12.03 ± 1.34, 10.66 ± 1.41, and 08.33 ± 0.62, respectively. The oral health-related quality of life was markedly improved after the reconstruction of the mandibular defects with free vascularized fibular flap and dental rehabilitation. The overall success rate of fibular flap in our study was 72.2%, which is lower than that reported in the literature. This may be attributed to the fact that almost all of our cases included large segmental defects that extended across the midline of the mandible.

Implant-supported prosthetic rehabilitation after Ameloblastomas treatment: a systematic review

“…In this sense, high success rates (91%) have been reported through the use of this type of graft [ 82 ], the most frequent complications being the presence of infections and wound dehiscence, loss of skin graft in the donor site, complete flap loss and percutaneous fistulas [ 83 ]. Furthermore, oral health-related quality of life has been shown to improve markedly in these patients [ 84 ]. Finally, it is expected that, with new technologies, such as virtual surgical planning with 3D models and cone beam computed tomography, more precise reconstructions can be made, reducing the risk of postoperative complications and favoring subsequent implant-supported prosthetic rehabilitation.…”

Exploring animal models in oral cancer research and clinical intervention: A critical review

“…Although there has been progress in understanding, diagnosing, and treating head and neck cancer, the 5‐year survival rate for this disease remains relatively low, especially for heavy smokers. As a result, improved detection and treatment of head and neck squamous cell carcinomas (HNSCC) are essential to improving outcomes and reducing complications (Anna Szymonowicz & Chen, 2020 ; Qayyum et al., 2023 ; Tahmasebi et al., 2023 ; Vardhan et al., 2022 ; Yadalam et al., 2022 ). Figure 1 shows that rodent species had keratinized their epithelium in all mucosal regions (Thirion‐Delalande et al., 2017 ).…”