骨筋膜与骨皮瓣游离腓骨下颌骨重建的早期结果。

Early outcomes of osteofascial versus osteocutaneous fibula free flap mandibular reconstruction.

机构信息

Department of Otolaryngology - Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel.

Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.

出版信息

Head Neck. 2024 May;46(5):1168-1177. doi: 10.1002/hed.27661. Epub 2024 Jan 26.

DOI:10.1002/hed.27661

PMID:38279002

Abstract

BACKGROUND

This study compares early outcomes of osteofascial fibula free flap (OF-FFF) with donor-site primary closure and osteocutaneous (OC) FFF with donor-site skin grafting in segmental mandibular reconstruction.

METHODS

A retrospective chart review of FFF mandibular reconstruction patients (2006-2022) divided into OF-FFF and OC-FFF groups. Clinical data, operative parameters, and early postoperative outcomes (≤ 90 days) were analyzed.

RESULTS

The study included 67 patients (39 OF-FFF, 28 OC-FFF). OF-FFF had significantly lower donor-site complications (12.8% vs. 53.6%, p < 0.001) and revision surgeries (7.7% vs. 35.7%, p = 0.004) compared to OC-FFF. Recipient-site (28.2% vs. 25%, p = 0.77) and flap (15.4% vs. 17.9%, p > 0.99) complications were comparable.

CONCLUSIONS

OF-FFF mandibular reconstruction with donor-site primary closure is a safe and reliable technique associated with superior donor-site and comparable flap and recipient-site outcomes to OC-FFF, thus may be considered as a viable alternative to OC-FFF for selected patients.

摘要

背景

本研究比较了骨筋膜腓骨游离皮瓣（OF-FFF）与供区一期闭合和骨皮（OC）FFF 与供区皮片移植在节段性下颌骨重建中的早期结果。

方法

回顾性分析了 2006 年至 2022 年间接受 FFF 下颌骨重建的患者（n=67），分为 OF-FFF 和 OC-FFF 组。分析了临床资料、手术参数和早期术后结果（≤90 天）。

结果

本研究包括 39 例 OF-FFF 和 28 例 OC-FFF。与 OC-FFF 相比，OF-FFF 供区并发症（12.8% vs. 53.6%，p<0.001）和修复手术（7.7% vs. 35.7%，p=0.004）发生率显著降低。受体部位（28.2% vs. 25%，p=0.77）和皮瓣（15.4% vs. 17.9%，p>0.99）并发症发生率无差异。