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Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study

Authors :
Zahid Qayyum
Zafar Ali Khan
Afsheen Maqsood
Namdeo Prabhu
Mohammed Saad Alqarni
Alzarea K. Bader
Rakhi Issrani
Maria Shakoor Abbasi
Naseer Ahmed
Mohammed Ghazi Sghaireen
Artak Heboyan
Source :
Healthcare, Vol 11, Iss 2, p 193 (2023)
Publication Year :
2023
Publisher :
MDPI AG, 2023.

Abstract

The objective of this study was to analyze the outcomes of the free vascularized fibular flap in the reconstruction of mandibular defects, and to assess the oral health impact profile of these patients before surgery and after oral rehabilitation. Patients requiring reconstruction of defects greater than 6 cm were selected for this study. The defect size and type, the size of the required skin paddle, the need for second flaps, the intraoperative complications, and the type of closure were documented. Patients were evaluated postoperatively for function, aesthetics, and donor- or reconstruction-site complications. The validated oral health impact profile (OHIP-14) questionnaires were filled before and after surgery and after dental rehabilitation. This study included 11 cases of squamous-cell carcinomas, 2 cases of malignant nerve sheath tumors, and 1 case each of malignant melanoma, ameloblastoma, giant-cell tumor, osteosarcoma, and chondrosarcoma. The analysis revealed a significant association (p = 0.030) of gender with free vascular flap complications, while no significant association (p > 0.05) was found when donor- and recipient- site complications, as well as the type of resection (Brown’s classification), were compared with free vascular flaps. Moreover, the total OHIP-14 scores for patients before surgery, after surgery, and after dental rehabilitation were 12.03 ± 1.34, 10.66 ± 1.41, and 08.33 ± 0.62, respectively. The oral health-related quality of life was markedly improved after the reconstruction of the mandibular defects with free vascularized fibular flap and dental rehabilitation. The overall success rate of fibular flap in our study was 72.2%, which is lower than that reported in the literature. This may be attributed to the fact that almost all of our cases included large segmental defects that extended across the midline of the mandible.

Details

Language :
English
ISSN :
22279032
Volume :
11
Issue :
2
Database :
Directory of Open Access Journals
Journal :
Healthcare
Publication Type :
Academic Journal
Accession number :
edsdoj.6c6d29101fcd4aba9a15c29a392503e7
Document Type :
article
Full Text :
https://doi.org/10.3390/healthcare11020193