Mandibular Reconstruction with Vascularized Fibular Graft: Comparing Outcomes of Adjuvant Radiotherapy Versus No-Radiotherapy

Authors

  • Noshi Bibi . Department of Surgery, Shifa International Hospital, Islamabad Pakistan
  • Mamoon Rashid . Department of Surgery, Shifa International Hospital, Islamabad Pakistan
  • Saad-ur-Rehman Department of Surgery, Shifa International Hospital, Islamabad Pakistan
  • Haroon-Ur-Rashid . Department of Surgery, Shifa International Hospital, Islamabad Pakistan
  • Farwa Shabbir . Department of Surgery, Shifa International Hospital, Islamabad Pakistan
  • Sakina Malik Department of Surgery, Shifa International Hospital, Islamabad Pakistan

DOI:

https://doi.org/10.51253/pafmj.v73i5.7659

Keywords:

Fibular graft, Mandibular reconstruction, Non-union, Plate exposure, Radiotherapy

Abstract

Objective: To compare the outcomes of mandibular reconstruction with vascularized fibular graft in adjuvant and nonradiotherapy Groups.

Study Design: Retrospective longitudinal study.

Place and Duration of Study: Plastic Surgery Department, Shifa International Hospital, Islamabad Pakistan, from 2010 to 2018.

Methodology: The data of 92 patients from 2010-2018 was included. Outcomes regarding local wound complications, wound dehiscence, fistula, skin necrosis, plate exposure and bone union rate were compared in Radiated (IR) and Non-Radiated (NR) Groups. Orthopantomography (OPG) was done at one month, six months, and one-year follow-up and was reviewed by a Radiologist.

Results: Ninety-two patients were included in the study, 56(60.9%) patients in the IR-Group and 36(39.1%) patients in the NRGroup. In the IR-Group, 56(60.9%) causes were intraoral squamous cell carcinoma in 51(91.0%) cases and osteosarcoma in 5(9.0%) cases. In NR-Group cases were ameloblastoma (15,41.6%), giant cell tumor (4,11.1%), craniofacial microsomia
(4,11.1%), osteonecrosis (6,16.6%) and trauma (7,19. 4%). Common complications were plate exposure (2.1%), wound
breakdown (10.8%) in the IR-Group, and, on the other hand, in the NR Group, wound breakdown noted in (3.2%)
respectively(p=0.05).

Conclusion: With our experience, adjuvant radiation is an important modality that increases survival rate and can be safely
administered without any significant complications related to soft tissue and reconstructed bone.

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Published

30-10-2023

Issue

Section

Original Articles

How to Cite

1.
. NB, . MR, Saad-ur-Rehman, . H-U-R, . FS, Sakina Malik. Mandibular Reconstruction with Vascularized Fibular Graft: Comparing Outcomes of Adjuvant Radiotherapy Versus No-Radiotherapy. Pak Armed Forces Med J [Internet]. 2023 Oct. 30 [cited 2024 Jul. 19];73(5):1288-92. Available from: https://pafmj.org/PAFMJ/article/view/7659