A 20-year experience of immediate mandibular reconstruction using free fibula osteocutaneous flaps following ameloblastoma resection: Radical resection, outcomes, and recurrence

Chai, Koh Siang; Omar, Farah Hany; Saad, Arman Zaharil Mat; Sulaiman, Wan Azman Wan; Halim, Ahmad Sukari

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자료유형: 학술저널

저자정보: Chai, Koh Siang (Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia) Omar, Farah Hany (Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia) Saad, Arman Zaharil Mat (Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia) Sulaiman, Wan Azman Wan (Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia) Halim, Ahmad Sukari (Reconstructive Sciences Unit, School of Medical Sciences, Universiti Sains Malaysia)

저널정보: 대한성형외과학회 Archives of plastic surgery : APS Archives of plastic surgery : APS 제46권 제5호

발행연도: 2019.1

수록면: 426 - 432 (7page)

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Background The mandible is an important structure that is located in the lower third of the face. Large mandibular defects after tumor resection cause loss of its function. This study assessed the outcomes and tumor recurrence after immediate mandibular reconstruction using a free fibula osteocutaneous flap following radical resection of ameloblastoma. Methods This is a retrospective non-randomized study of outcomes and tumor recurrence of all patients diagnosed with mandibular ameloblastoma from August 1997 until August 2017 (20 years) requiring free fibula osteocutaneous flap reconstruction at a single institution. The patients were identified through an electronic operative database; subsequently, their medical records and photo documentation were retrieved. Results Twenty-seven patients were included in this study. Eighteen patients were male, while nine were female. The majority of the patients (48.1%) were in their third decade of life when they were diagnosed with ameloblastoma. All of them underwent radical resection of the tumor with a surgical margin of 2 cm (hemimandibulectomy in cases with a large tumor) and immediate mandibular reconstruction with a free fibula osteocutaneous flap. Two patients required revision of a vascular anastomosis due to venous thrombosis postoperatively, while one patient developed a flap recipient site infection. The flap success rate was 100%. There was no tumor recurrence during a mean follow-up period of 5.6 years. Conclusions Mandibular ameloblastoma should be treated with segmental mandibulectomy (with a surgical margin of 2 cm) to reduce the risk of recurrence. Subsequent mandibular and adjacent soft tissue defects should be reconstructed immediately with a free fibula osteocutaneous flap.

#Ameloblastoma #Mandibular reconstruction #Free tissue flaps

참고문헌 (21)

참고문헌 신청

Effiom OA / 2018 / Ameloblastoma : current etiopathological concepts and management / Oral Dis 24:307~316

McClary AC / 2016 / Ameloblastoma : a clinical review and trends in management / Eur Arch Otorhinolaryngol 273:1649~1661

Wang YY / 2016 / Mandibular reconstruction with the vascularized fibula flap: comparison of virtual planning surgery and conventional surgery / Int J Oral Maxillofac Surg 45:1400~1405

Gbara A / 2007 / Long-term results of jaw reconstruction with microsurgical fibula grafts and dental implants / J Oral Maxillofac Surg 65:1005~1009

Brown JS / 2017 / Mandibular reconstruction with vascularised bone flaps : a systematic review over 25 years / Br J Oral Maxillofac Surg 55:113~126

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