Diarra Drissa, Chen Jialiang, Lin Hao, Zeng Bang, Man Qiwen, Deng Weiwei, Nyimi Bushabu Fidele, Wu Tianfu, Liu Bing
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China.
State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China; Department of Oral & Maxillofacial Head Neck Oncology, School & Hospital of Stomatology, Wuhan University, Wuhan, PR China.
J Stomatol Oral Maxillofac Surg. 2025 Jun;126(3S):102322. doi: 10.1016/j.jormas.2025.102322. Epub 2025 Mar 26.
This retrospective study aims to evaluate and compare the morphological and functional characteristics of mandibular reconstructions performed using iliac and fibular flaps to determine their respective effectiveness and identify the technique that offers the best patient outcomes.
Medical and imaging data were analysed from pre- and post-operative scans of 121 patients (84 with iliac flaps and 37 with fibular flaps). Mandibular reconstructions were assessed by comparing morphometric parameters (distances and angles) and symmetry between the affected and unaffected sides using Mimics software. The quality of life of patients was assessed using a modified version of the University of Washington Quality of Life Questionnaire (UW-QOL), version 4, which evaluates functional and psychosocial outcomes in head and neck cancer treatment RESULTS: The results show that the iliac group demonstrates significantly superior performance for distances D2 and D3 and for the CA angle on the unaffected side. In contrast, the fibular group shows no significant advantage in these parameters. Regarding symmetry, the iliac group achieves better results for distance D3, whereas the fibular group excels in angular measurements. Additionally, the iliac group maintains better stability for angle B. Regarding bone dimensions, the iliac flap better preserves alveolar base height (ABH) and width (ABW), providing more consistent and favorable outcomes than the fibular flap.No overall difference was observed between the two groups regarding quality of life (assessed using the UW-QOL questionnaire). However, specific variations were noted: the fibular group scores higher for pain, activity, and recreation, while the iliac group achieves better results in appearance and speech.
The iliac flaps are the preferred option for mandibular reconstruction, offering superior morphometric stability, better preservation of bone dimensions, and more robust structural consistency than fibular flaps. Although both techniques yield comparable overall quality-of-life results, iliac flaps demonstrate more pronounced clinical benefits, leading to optimal postoperative outcomes.
本回顾性研究旨在评估和比较使用髂骨瓣和腓骨瓣进行下颌骨重建的形态学和功能特征，以确定它们各自的有效性，并找出能为患者带来最佳治疗效果的技术。
分析了121例患者（84例使用髂骨瓣，37例使用腓骨瓣）术前和术后扫描的医学和影像数据。使用Mimics软件通过比较形态测量参数（距离和角度）以及患侧和健侧之间的对称性来评估下颌骨重建情况。使用华盛顿大学生活质量问卷（UW-QOL）第4版的修订版评估患者的生活质量，该问卷评估头颈癌治疗中的功能和心理社会结果。结果：结果显示，髂骨瓣组在健侧的距离D2和D3以及CA角方面表现明显更优。相比之下，腓骨瓣组在这些参数上没有显著优势。在对称性方面，髂骨瓣组在距离D3上取得了更好的结果，而腓骨瓣组在角度测量方面表现出色。此外，髂骨瓣组在角度B上保持了更好的稳定性。在骨尺寸方面，髂骨瓣能更好地保留牙槽基底部高度（ABH）和宽度（ABW），比腓骨瓣提供更一致和有利的结果。两组在生活质量（使用UW-QOL问卷评估）方面没有观察到总体差异。然而，注意到了具体差异：腓骨瓣组在疼痛、活动和娱乐方面得分更高，而髂骨瓣组在外观和言语方面取得了更好的结果。
髂骨瓣是下颌骨重建的首选选项，与腓骨瓣相比，具有更高的形态测量稳定性、更好地保留骨尺寸以及更强的结构一致性。虽然两种技术产生的总体生活质量结果相当，但髂骨瓣显示出更显著的临床益处，从而带来最佳的术后效果。
