Application of microvascular free osteocutaneous flaps in the management of post-radiation recurrent oral cancer |
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| Authors: | I B Rosen R T Manktelow R M Zuker B Boyd |
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| Affiliation: | 1. Department of Maxillofacial and Facial Plastic Surgery, Central Medical Center Bremen, Germany;2. Institute of Anatomy, University of Leipzig, Germany;3. Department of Orthodontics, University Medical Center Goettingen, Germany;1. Department of Psychology, Faculty of Health, York University, Toronto, Canada;2. Department of Psychology, National Research University Higher School of Economics, Moscow, Russian Federation;1. University of Gondar, College of Medicine and Health Sciences, School of Pharmacy, Department of Pharmacology, Gondar, Ethiopia;2. University of Gondar, College of Medicine and Health Sciences, School of Pharmacy, Department of Clinical Pharmacy, Gondar, Ethiopia;1. Medanta - The Medicity, Gurgaon, Haryana, India;2. Shah Satnam Ji Specialty Hospital, Sirsa, Haryana, India;3. Duke University Medical Center, Durham, North Carolina;4. Methodist DeBakey Heart & Vascular Centre, Houston, Texas;5. Sengupta Hospital and Research Center, Nagpur, Maharashtra, India;6. Mayo Clinic, Rochester, Minnesota;7. Mount Sinai Medical Center, New York, New York |
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| Abstract: | Fifty-nine patients underwent free flap osteocutaneous reconstruction that consisted of flaps of the dorsum of the foot in 26 patients and iliac crest flaps in 33 with a success rate of 92 percent and a mortality rate of 1.6 percent. These flaps, which require the expertise of microvascular surgeons, are time-consuming and complicate operating room and time management, but they represent a remarkable advance in reconstruction that can facilitate cosmetic and functional recovery of the patient. In particular, they promote healing in radiation-recurrent oral cancer and represent a definitive form of management for established radionecrosis of the mandible. The large volume of tissue available with iliac crest osteocutaneous grafts permits the management of patients with extensive cancer involving the skin, mucosa, and bone, but cancer control may still be disappointing and there is a need for improved adjuvant chemotherapy protocols. This technique appears to be a dependable, repeatable, and significant advance in management of the patient with head and neck cancer. |
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