游离腓骨瓣重建下颌骨放射性骨坏死术后晚期并发症的发生情况及治疗结果
Occurrence and Treatment Outcome of Late Complications After Free Fibula Flap Reconstruction for Mandibular Osteoradionecrosis.
作者信息
Yamashita Junya, Akashi Masaya, Takeda Daisuke, Kusumoto Junya, Hasegawa Takumi, Hashikawa Kazunobu
机构信息
Oral and Maxillofacial Surgery, Kobe University Hospital, Kobe, JPN.
Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, JPN.
出版信息
Cureus. 2021 Mar 11;13(3):e13833. doi: 10.7759/cureus.13833.
PURPOSE
This study aimed to evaluate the occurrence and treatment outcome of late complications after free fibula osteocutaneous flap reconstruction for mandibular osteoradionecrosis (ORN).
METHODS
We enrolled 15 consecutive patients (14 men, one woman; median age 65 years, range 57-80 years) who underwent free fibula reconstruction for advanced mandibular ORN during 2013-2017 with two or more years of follow-up. Late complications included infection, plate exposure, and recurrence at the resection margin. The effect of perioperative antibiotic administration on late complications was also assessed.
RESULTS
Late complications occurred in 33.3% (5/15) of patients, including two infections (local and distant), two plate exposures, and two recurrences (plate exposure and recurrence occurred in one patient). Perioperative antibiotic administration duration did not significantly affect the occurrence of postoperative late complications. All late complications were treated without problems.
CONCLUSIONS
Late complications after ORN reconstructive surgery are not uncommon, but can be treated properly.
目的
本研究旨在评估游离腓骨骨皮瓣重建下颌骨放射性骨坏死（ORN）后晚期并发症的发生情况及治疗效果。
方法
我们纳入了15例连续患者（14例男性，1例女性；中位年龄65岁，范围57 - 80岁），这些患者在2013年至2017年间接受了游离腓骨重建术治疗晚期下颌骨ORN，并进行了两年或更长时间的随访。晚期并发症包括感染、钢板外露和切缘复发。还评估了围手术期抗生素给药对晚期并发症的影响。
结果
33.3%（5/15）的患者出现晚期并发症，包括2例感染（局部和远处）、2例钢板外露和2例复发（1例患者出现钢板外露和复发）。围手术期抗生素给药持续时间对术后晚期并发症的发生没有显著影响。所有晚期并发症均得到妥善治疗。
结论
ORN重建手术后的晚期并发症并不罕见，但可以得到妥善治疗。
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