Comparison of reconstructive procedures in primary versus secondary mandibular reconstruction

Background. Few reports have compared reconstructive outcomes of primary versus secondary mandibular reconstruction. Methods. A retrospective chart review was performed on 149 patients following primary (n = 110) and secondary reconstruction (n = 39). Results. There was no statistically significant difference in patient demographics between the 2 groups. The secondary reconstruction mandibular defects were more extensive; significanfly more involved the concyle or the central portion of the mandible, The vascularized fibular flap was most commonly used (primary 82%, secondary 69%). The overall complication rate was similar in both groups. There was no statistical difference in the frequency of complications between the primary or secondary reconstruction groups (acute, p =.40; late, p=.17). Conclusions. Success in secondary mandibular reconstruction could be achieved utilizing a range of osseous free flaps, and there was no increased rate of complications compared with primary mandibular reconstructions. (c) 2007 Wiley Periodicals, Inc.