1. Association of Plate Contouring With Hardware Complications Following Mandibular Reconstruction
- Author
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Harley H.L. Chan, David P. Goldstein, Peter R. Dixon, Ralph W. Gilbert, Jonathan C. Irish, Hedyeh Ziai, Douglas B. Chepeha, John R. de Almeida, Christopher M. K. L. Yao, and Joel C. Davies
- Subjects
Adult ,Male ,Adolescent ,Mandibular Osteotomy ,Dehiscence ,Logistic regression ,Free Tissue Flaps ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,030223 otorhinolaryngology ,Aged ,Retrospective Studies ,Aged, 80 and over ,Contouring ,business.industry ,Retrospective cohort study ,Odds ratio ,Middle Aged ,Confidence interval ,Mandibulectomy ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,Female ,Mandibular Reconstruction ,business ,Bone Plates ,Computer hardware ,Cohort study - Abstract
OBJECTIVES/HYPOTHESIS Despite considerable effort being dedicated to contouring reconstruction plates, there remains limited evidence demonstrating an association between contour and reconstructive outcomes. We sought to evaluate whether optimizing mandibular reconstruction plate contouring is associated with reduced postoperative hardware complications. STUDY DESIGN Retrospective cohort study. METHODS A cohort study was performed with adult patients (age ≥18 years) who underwent mandibulectomy and osseous free flap reconstruction following oncologic ablation at the University Health Network in Toronto, Canada, between January 1, 2003 and December 31, 2014. Patients with computed tomography scans performed within 1 year of reconstruction were included. Computer-based three-dimensional models were generated and used to calculate the mean plate-to-bone gap (mm). The primary outcome was plate exposure. Secondary outcome included a composite of plate exposure or intraoral dehiscence. Logistic regression models were fitted for each outcome accounting for other patient and surgical characteristics associated with the primary outcome. RESULTS Ninety-four patients met inclusion criteria, with a mean age of 60.4 (standard deviation [SD] 14.9). The mean follow-up time was 31.4 months (range 3-94). Reconstruction was performed with fibular (57%) and scapular free flaps (43%). In the multivariable model, small mean plate-to-bone gap (
- Published
- 2021