Støre G, Boysen M, Skjelbred P
Department of Otolaryngology, Rikshospitalet University Hospital, Oslo, Norway.
Clin Otolaryngol Allied Sci. 2002 Jun;27(3):197-203. doi: 10.1046/j.1365-2273.2002.00564.x.
Osteoradionecrosis of the mandible is a serious complication following radiotherapy of head and neck cancers. A retrospective study of 20 reconstructions of mandibular defects due to osteoradionecrosis was performed. Various osseocutaneous free flaps were used: upper lateral arm (n = 5), radial forearm (n = 1), iliac crest (n = 4) and fibula (n = 7). Four grafts had a condylar prosthesis, and for seven grafts fixation was accomplished with a reconstruction plate. In three patients the mandibular defect was reconstructed using a bridging plate only. We defined a successful reconstruction as a graft or plate that did not need removal. Success was noted in 15 out of 20 patients, giving an overall success rate of 75%. For the free grafts alone (n = 17), successful reconstruction was achieved in 15 patients (88%). Two fibular grafts were lost owing to exposure and infection, as well as all three alloplastic reconstructions. Minor postoperative complications were observed in 11 patients (58%).
下颌骨放射性骨坏死是头颈部癌症放疗后的一种严重并发症。对20例因放射性骨坏死导致下颌骨缺损的修复病例进行了回顾性研究。使用了各种骨皮瓣：上臂外侧（n = 5）、桡骨前臂（n = 1）、髂嵴（n = 4）和腓骨（n = 7）。4例移植采用髁突假体，7例移植用重建钢板固定。3例患者仅使用桥接钢板重建下颌骨缺损。我们将成功的重建定义为无需取出的移植或钢板。20例患者中有15例成功，总体成功率为75%。仅就游离移植（n = 17）而言，15例患者（88%）实现了成功重建。2例腓骨移植因暴露和感染失败，所有3例异体材料重建均失败。11例患者（58%）出现轻微术后并发症。
