Comparison of reconstruction plate and double flap for reconstruction of an extensive mandibular defect

Microsurgery, 04/03/2012

Double flap transfer provides a more stable wound closure than MRP and should be the preferred reconstructive procedure if the patients can tolerate the associated operative stresses.

Methods

  • In this retrospective study, clinical results were compared between mandibular reconstruction plate (MRP) procedures and double flap transfers.
  • The subjects were 23 patients who underwent immediate reconstruction, after an anterior segmental mandibulectomy in combination with a significant glossectomy, from 1993 to 2009.
  • The patients were divided into two groups based on the reconstructive methods used: MRP and soft tissue free flap transfer (MRP group: 12 patients) or double free flap transfer (double flap group: 11 patients).
  • Operative stress, postoperative complications and oral intake ability were compared between the groups.

Results

  • The rate of recipient–site complication in the double flap group tended to be lower than that in the MRP group.
  • The most frequent complications in the MRP group included infection and orocutaneous fistula.
  • Operative stresses (operation time and blood loss) were significantly less in the MRP group than in the double flap group.
  • Overall, 19 patients (82.6%) were able to tolerate an oral diet without the need for tube feeding.
  • This study demonstrates that laryngeal preservation is possible in more than 80% of patients even after such an extensive ablation.

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