The role of the osteocutaneous radial forearm free flap in the treatment of mandibular osteoradionecrosis

Oleg N. Militsakh, Derrick I. Wallace, J. David Kriet, Terance T. Tsue, Douglas A. Girod

Research output: Contribution to journalArticle

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Abstract

OBJECTIVE: To evaluate the role of the osteocutaneous radial forearm free flap (OCRFFF) in the treatment of mandibular osteoradionecrosis (ORN). STUDY DESIGN AND SETTING: Retrospective case review of patients who underwent OCRFFF oromandibular reconstruction after resection of nonviable tissue at an academic tertiary care center because of ORN. Patients with reconstructions other than OCRFFF were excluded from this study. RESULTS: Nine patients underwent a composite oromandibular resection for ORN with a reconstruction using an OCRFFF between April 1998 and February 2003. All patients had failed previous less aggressive surgical and medical management of the ORN. Mean follow-up was 36 months (range, 14-67 months). There were no flap failures or significant immediate postoperative or long-term complications observed. All patients had successful restoration of mandibular integrity and continuity, with 100% success rate of stabilization of ORN. All patients were able to tolerate PO diet, with only one third having to supplement their diet with gastrostomy feedings, compared with 89% gastrostomy dependence preoperatively. CONCLUSIONS: Primary or adjuvant radiotherapy for head and neck malignancies can result in ORN of the mandible. This difficult problem often requires surgical intervention. In our experience, the OCRFFF can be successfully used for oromandibular reconstruction, even in the setting of the heavily radiated tissue with excellent postoperative outcomes. SIGNIFICANCE: This is the first study that demonstrates the efficacy of the OCRFFF as a treatment of mandibular ORN.

Original languageEnglish (US)
Pages (from-to)80-83
Number of pages4
JournalOtolaryngology - Head and Neck Surgery
Volume133
Issue number1
DOIs
StatePublished - Jul 2005

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Osteoradionecrosis
Free Tissue Flaps
Forearm
Gastrostomy
Therapeutics
Diet
Adjuvant Radiotherapy
Mandible
Tertiary Care Centers
Neck
Head

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

The role of the osteocutaneous radial forearm free flap in the treatment of mandibular osteoradionecrosis. / Militsakh, Oleg N.; Wallace, Derrick I.; Kriet, J. David; Tsue, Terance T.; Girod, Douglas A.

In: Otolaryngology - Head and Neck Surgery, Vol. 133, No. 1, 07.2005, p. 80-83.

Research output: Contribution to journalArticle

Militsakh, Oleg N. ; Wallace, Derrick I. ; Kriet, J. David ; Tsue, Terance T. ; Girod, Douglas A. / The role of the osteocutaneous radial forearm free flap in the treatment of mandibular osteoradionecrosis. In: Otolaryngology - Head and Neck Surgery. 2005 ; Vol. 133, No. 1. pp. 80-83.
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