Mandibular Reconstruction With Iliac Crest Free Flap, Nasolabial Flap, and Osseointegrated Implants

被引:19
作者
Navarro Cuellar, Carlos [1 ]
Ochandiano Caicoya, Santiago Jose
Acero Sanz, Julio Jesus [2 ]
Navarro Cuellar, Ignacio
Maza Muela, Cristina
Navarro Vila, Carlos [1 ,3 ]
机构
[1] Univ Complutense Madrid, Sch Med, Madrid, Spain
[2] Hosp Ramon & Cajal, Oral & Maxillofacial Dept, E-28034 Madrid, Spain
[3] Hosp Gen Gregorio Maranon, Oral & Maxillofacial Dept, Madrid 28007, Spain
关键词
OROMANDIBULAR RECONSTRUCTION; BONE-GRAFT;
D O I
10.1016/j.joms.2014.02.031
中图分类号
R78 [口腔科学];
学科分类号
1003 ;
摘要
Purpose: Oncologic patients undergoing segmental mandibulectomy with soft tissue resection develop several esthetic and functional sequelae; therefore, the defect must be reconstructed immediately. The iliac crest flap is the only flap that allows reconstruction of the previous dimensions of the mandible. However, the excessive soft tissue of this flap prevents optimal reconstruction of intraoral soft tissue defects. Materials and Methods: This report describes a reconstructive technique used in 12 patients who underwent segmental mandibulectomy because of soft tissue defects resulting from tumor resection. The technique involves reconstruction of the mandible using an iliac crest flap combined with a nasolabial flap to enable subsequent reconstruction of the intraoral soft tissue and immediate placement of osseointegrated implants. Results: The osseointegration success rate was 95.2% with a failure rate of 4.8%. Failure particularly affected the irradiated patients. Excellent functional and aesthetic results were obtained with the iliac crest free flap, nasolabial flap and osseointegrated dental implants. Conclusions: This technique has several advantages. On the one hand, it enables reconstruction of the original dimensions of the mandible, thus allowing immediate placement of implants in an ideal position for subsequent rehabilitation with a dental prosthesis. On the other hand, the nasolabial flap provides a thin layer of tissue that can be used to reconstruct the anatomy of the oromandibular soft tissue. (C) 2014 American Association of Oral and Maxillofacial Surgeons
引用
收藏
页码:1226.e1 / 1226.e15
页数:15
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