Complications in oncologic mandible reconstruction: A comparative study between the osteocutaneous radial forearm and fibula free flap. Issue 2 (18th November 2021)

• Record Type: Journal Article
• Authors: Le, John M.; Morlandt, Anthony B.; Gigliotti, Jordan; Park, Earl P.; Greene, Benjamin J.; Ying, Yedeh P.
• Is Part Of: Microsurgery. Volume 42:Issue 2(2022)
• Page Start: 150
• Page End: 159
• Publication Date: 2021-11-18
• Subjects: Microsurgery -- Periodicals; 617.05
• DOI: 10.1002/micr.30841
• Languages: English
• ISSNs: 0738-1085

Abstract

Abstract: Background: The osteocutaneous radial forearm free flap (OC‐RFFF) has been proposed as a safe and reliable free flap for head and neck reconstruction with low donor site morbidity. The purpose of this study is to compare the late complications (>30 days) associated with using the OC‐RFFF versus the free fibula flap (FFF) for mandibular reconstruction following oncologic segmental resection. Methods: We conducted a single‐institution, retrospective study composed of patients who underwent oncologic microvascular composite mandibular reconstruction with either the OC‐RFFF or FFF. The primary predictor variable was the type of free flap used. The outcome variable was late complication postoperatively (>30 days). Results: A total of 93 patients (28, OC‐RFFF and 65, FFF) were analyzed. The majority of patients were male (62%) and with AJCC stage T4a disease (72%). Mean hospital length of stay was comparable between the two flap groups ( p = .50). OC‐RFFF was associated with more late complications ( p = .03) compared to FFF. Nonunion occurred in 10.7% of OC‐RFFF and 0% of FFF. Partial or complete flap failure was seen in 7.1% and 0% in the OC‐RFFF and FFF, respectively. Two‐year disease‐free survival was comparable in both groups ( p > .05). Conclusions: The results of this study suggest that the rate of nonunion and odds of having a late complication were significantly greater in the OC‐RFFF compared to the FFF following oncologic mandibular reconstruction. However, flap success, early complications (<30 days), and length of hospital stay were comparable between the two flaps.