Risk Factors and Surgical Refinements of Postresective Mandibular Reconstruction: A Retrospective StudyReport as inadecuate




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Plastic Surgery InternationalVolume 2014 2014, Article ID 893746, 8 pages

Clinical Study

Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan

Department of Plastic Surgery, Kobe University Graduate School of Medicine, Kobe 650-0017, Japan

Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, Gunma 371-8511, Japan

Department of Plastic Surgery, Japanese Red Cross Kobe Hospital, Kobe 651-0073, Japan

Received 16 May 2014; Revised 18 July 2014; Accepted 18 July 2014; Published 6 August 2014

Academic Editor: Francesco Carinci

Copyright © 2014 Akiko Sakakibara et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Postresective mandibular reconstruction is common in cases of oral and mandibular tumors. However, complications such as infection, plate exposure, or plate fracture can occur. We identified several significant risk factors of complications after reconstructive surgery and compared the effectiveness of different surgical techniques for reducing the incidence of complications. Methods. This study is a retrospective analysis of 28 oromandibular cancer cases that required reconstructive surgery between January 1999 and December 2011 at Kobe University Graduate School of Medicine in Japan. All cases were classified using Hashikawa’s CAT and Eichner’s classification methods. Then, we determined whether these classifications and different treatment or surgical methods were significantly related to complications. Results. Complications after mandibular reconstruction occurred in 10-28 patients 36%. Specifically, five patients had plate fractures, four had plate exposures, and one had an infection. Radiation therapy and closure without any flaps were significantly related to infection or plate exposure. The wrap-around technique of securing reconstruction plates was used in 14 cases, whereas the run-through technique was used in two cases. Conclusions. The success of mandibular reconstruction depends on both mechanical and biological factors, such as the location of defects, presence of occlusions, and the amount of vascularization of the flap.





Author: Akiko Sakakibara, Kazunobu Hashikawa, Satoshi Yokoo, Shunsuke Sakakibara, Takahide Komori, and Shinya Tahara

Source: https://www.hindawi.com/



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