Choice of osseous and osteocutaneous flaps for mandibular reconstruction

被引：55
作者：
Takushima A. [1 ]
Harii K. [1 ]
Asato H. [2 ]
Momosawa A. [1 ]
Okazaki M. [2 ]
Nakatsuka T. [3 ]
机构：
[1] Department of Plastic and Reconstructive Surgery, School of Medicine, Kyorin University, Mitaka, Tokyo 181-8611
[2] Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, University of Tokyo, Tokyo
[3] Department of Plastic and Reconstructive Surgery, Saitama Medical School, Saitama
来源：
International Journal of Clinical Oncology | 2005年 / 10卷 / 4期
关键词：
Flap; Mandible; Microsurgery; Reconstruction;
D O I：
10.1007/s10147-005-0504-y
中图分类号：
学科分类号：
摘要：
Microvascular free flap transfer currently represents one of the most popular methods for mandibular reconstruction. With the various free flap options now available, there is a general consensus that no single kind of osseous or osteocutaneous flap can resolve the entire spectrum of mandibular defects. A suitable flap, therefore, should be selected according to the specific type of bone and soft tissue defect. We have developed an algorithm for mandibular reconstruction, in which the bony defect is termed as either "lateral" or "anterior" and the soft-tissue defect is classified as "none," "skin or mucosal," or "through-and-through." For proper flap selection, the bony defect condition should be considered first, followed by the soft-tissue defect condition. When the bony defect is "lateral" and the soft tissue is not defective, the ilium is the best choice. When the bony defect is "lateral" and a small "skin or mucosal" soft-tissue defect is present, the fibula represents the optimal choice. When the bony defect is "lateral" and an extensive "skin or mucosal" or "through-and-through" soft-tissue defect exists, the scapula should be selected. When the bony defect is "anterior," the fibula should always be selected. However, when an "anterior" bone defect also displays an "extensive" or "through-and-through" soft-tissue defect, the fibula should be used with other soft-tissue flaps. Flaps such as a forearm flap, anterior thigh flap, or rectus abdominis musculocutaneous flap are suitable, depending on the size of the soft-tissue defect. © The Japan Society of Clinical Oncology 2005.
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页码：234 / 242
页数：8
相关论文
共 85 条
  • [31] MacLeod A.M., Robinson D.W., Reconstruction of defects involving the mandible and floor of mouth by free osteo-cutaneous flaps derived from the foot, Br J Plast Surg, 35, pp. 239-246, (1982)
  • [32] Daniel R.K., Mandibular reconstruction with free tissue transfers, Ann Plast Surg, 1, pp. 346-371, (1978)
  • [33] Taylor G.I., Townsend P., Corlett R., Superiority of the deep circumflex iliac vessels as the supply for free groin flaps. Clinical work, Plast Reconstr Surg, 64, pp. 745-759, (1979)
  • [34] Salibian A.H., Rappaport I., Allison G., Functional oromandibular reconstruction with the microvascular composite groin flap, Plast Reconstr Surg, 76, pp. 819-828, (1985)
  • [35] Teot L., Bosse J.P., Mourfarrege R., The scapular crest pedicled bone graft, Int J Microsurg, 3, pp. 257-262, (1981)
  • [36] Swartz W.M., Banis J.C., Newton E.D., The osteocutaneous scapular flap for mandibular and maxillary reconstruction, Plast Reconstr Surg, 77, pp. 530-545, (1986)
  • [37] Baker S.R., Sullivan M.J., Osteocutaneous free scapular flap for one-stage mandibular reconstruction, Arch Otolaryngol Head Neck Surg, 114, pp. 267-277, (1988)
  • [38] Hidalgo D.A., Fibula free flap: A new method of mandible reconstruction, Plast Reconstr Surg, 84, pp. 71-79, (1989)
  • [39] Flemming A.F., Brough M.D., Evans N.D., Mandibular reconstruction using vascularised fibula, Br J Plast Surg, 43, pp. 403-409, (1990)
  • [40] Wei F.C., Seah C.S., Tsai Y.C., Fibula osteoseptocutaneous flap for reconstruction of composite mandibular defects, Plast Reconstr Surg, 93, pp. 294-304, (1994)
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