Reconstruction of composit oromandibular defects

Abstract

Objective: Mandibular defects are generally observed as composite defects which soft tissue defects are accompanied to bone defects. This situation may cause difficulties in choosing the surgical method during the reconstruction period. The purpose of this paper is to convey our clinical approach and results on composite mandibular defects. Methods: Eleven patients, applying to our clinic between 2011 and 2015, were operated in a single session with the team of otorhinolaryngology, because of oromandibular cancer. Ten of the patients were male and one was woman. The age range was between 7 and 54 ages (Average age 35.5). Results: While mandibular resection was performed on all patients, skin resection was performed on six patients, mucosa resection was applied on eight patients; and floor of mouth resections on four patients. The occurring composite defects were reconstructed with free fibular flap or free anterolateral thigh flap. In postoperative period total flap loss was observed in one patient, an infection got developed in the flap donor area of one patient. In the long term, distant metastasis was observed in two patients and local relapse in one patient. Discussion: In the repair of composite mandibular defects, fibula free flap can be considered as the first option with regard to its bone length, suitability for osteotomy and low donor area morbidity. However, in these cases, it is necessary to consider the patient's age, health condition, location and type of defect in the determination of the suitable reconstruction method.