期刊
CURRENT OPINION IN OTOLARYNGOLOGY & HEAD AND NECK SURGERY
卷 20, 期 4, 页码 231-236出版社
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1097/MOO.0b013e328355d0f3
关键词
computer-generated modeling; free flaps; mandible reconstruction; osteonecrosis
Purpose of review This article reviews literature pertaining to advances in the reconstruction of segmental mandibular defects in the context of an established standard of care, microvascular transfer of free osteocutaneous flaps. Recent findings Most literature reiterates established reconstructive techniques. Exceptions include the use of computer-assisted modeling to preoperatively design the excision of both the mandible and fibula segments and to produce a template for contouring the neomandible, the design of new flaps, distraction osteogenesis and techniques for dealing with osteonecrosis. Summary The microvascular transfer of free osteocutaneous flaps remains the standard of care, with the fibula flap the clear favorite. Review of the evolution of this flap for segmental mandibular reconstruction provides the bulk of the literature. Improvement on this standard of practice continues to be elusive, in large part because of the effects of associated radiation. Tissue engineering holds promise but no current practical application is available.
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