[Results of resection and simultaneous reconstruction of the mandible in osteomyelitis and radioosteomyelitis].

Results after simultaneous resection and reconstruction of the mandible in odontogenic osteomyelitis and in radio-osteomyelitis are reported from the Department of Maxillofacial Surgery, University Hospital Zurich. In addition a comparative study is presented in cases of radioosteomyelitis of simultaneous resection and reconstruction and of resection and secondary reconstruction after an interval free of infection. The results after simultaneous reconstruction in cases of odontogenic osteomyelitis are identical to those achieved in non-infected cases. The results after simultaneous reconstruction in cases of radioosteomyelitis seem to be superior to those of secondary reconstruction after an infection free interval. In both groups a high rate of complications is found; their management need extensive experience in reconstructive maxillofacial surgery. Whenever possible we perform nowadays the replacement of hard and soft tissues in severe cases of radioosteomyelitis, f.i. using the pedicled temporalis muscle flap plus a free bone graft or the osteomyocutaneous pectoralis major flap. The use of free microvascular tissue transfer in high dose irradiated patients with uni- or bilateral neck dissection seems less suitable than expected.