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Osteocutaneous free flaps for mandibular reconstruction: systematic review of their frequency of use and a preliminary quality of life comparison

Published online by Cambridge University Press:  17 November 2014

S P Moubayed ,
B L'Heureux-Lebeau ,
A Christopoulos ,
J S Sampalis ,
L Letourneau-Guillon ,
E Bissada ,
L Guertin ,
P G Harris ,
A M Danino  and
T Ayad
S P Moubayed
Affiliation:
Otolaryngology-Head and Neck Surgery Service, Department of Surgery, Université de Montréal Hospital Center, Montreal, Canada Division of Surgical Research, McGill University, Montreal, Canada
B L'Heureux-Lebeau
Affiliation:
Otolaryngology-Head and Neck Surgery Service, Department of Surgery, Université de Montréal Hospital Center, Montreal, Canada
A Christopoulos
Affiliation:
Otolaryngology-Head and Neck Surgery Service, Department of Surgery, Université de Montréal Hospital Center, Montreal, Canada
J S Sampalis
Affiliation:
Division of Surgical Research, McGill University, Montreal, Canada
L Letourneau-Guillon
Affiliation:
Department of Radiology, Université de Montréal Hospital Center, Montreal, Canada
E Bissada
Affiliation:
Otolaryngology-Head and Neck Surgery Service, Department of Surgery, Université de Montréal Hospital Center, Montreal, Canada
L Guertin
Affiliation:
Otolaryngology-Head and Neck Surgery Service, Department of Surgery, Université de Montréal Hospital Center, Montreal, Canada
P G Harris
Affiliation:
Plastic and Reconstructive Surgery Service, Department of Surgery, Université de Montréal Hospital Center, Montreal, Canada
A M Danino
Affiliation:
Plastic and Reconstructive Surgery Service, Department of Surgery, Université de Montréal Hospital Center, Montreal, Canada
T Ayad*
Affiliation:
Otolaryngology-Head and Neck Surgery Service, Department of Surgery, Université de Montréal Hospital Center, Montreal, Canada
*
Address for correspondence: Dr T Ayad, Otolaryngology-Head and Neck Surgery Service, Department of Surgery, Notre-Dame Hospital, Université de Montréal Hospital Center, 1560 Sherbrooke E, Montreal, Canada H2L 4M1 Fax: +1 514 412-7760 E-mail: [email protected]
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Abstract

Objectives:

To determine whether the fibula free flap is the most frequently used osteocutaneous flap for mandible reconstruction, and whether it provides quality of life, depression and anxiety advantages.

Methods:

A systematic review of the public Medline database was conducted. Thirteen patients who underwent mandibular reconstruction at our hospital centre completed questionnaires to evaluate quality of life, depression and anxiety outcomes.

Results:

The most frequently used free flaps are those of the fibula (n = 982), radial forearm (n = 201), iliac crest (n = 113), subscapular system (n = 50) and rib–serratus (n = 7). In our patient population, there was a trend towards a better quality of life in those with a fibula free flap. However, patients in this group were significantly younger than patients with other flap types (p = 0.025). Patients with a subscapular system free flap were more depressed (p = 0.031); however, they had large through-and-through defects.

Conclusion:

The flap used most frequently in the literature is the fibula free flap. Comparative quality of life data are lacking, and homogeneous populations should be used to reach significant conclusions.

Keywords

Quality of LifeMandibular ReconstructionFree Tissue FlapsOral Cancer
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 12 , December 2014 , pp. 1034 - 1043
Copyright
Copyright © JLO (1984) Limited 2014 

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References

1Thorne, C, Grabb, WC, Smith, JW. Grabb and Smith's Plastic Surgery, 6th edn.Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins, 2007Google Scholar
2Spilker, B. Quality of life and pharmacoeconomics in clinical trials, 2nd edn.New York: Raven Press, 1996Google Scholar
3Cordeiro, PG, Disa, JJ, Hidalgo, DA, Hu, QY. Reconstruction of the mandible with osseous free flaps: a 10-year experience with 150 consecutive patients. Plast Reconstr Surg 1999;104:1314–20CrossRefGoogle ScholarPubMed
4Lydiatt, WM, Denman, D, McNeilly, DP, Puumula, SE, Burke, WJ. A randomized, placebo-controlled trial of citalopram for the prevention of major depression during treatment for head and neck cancer. Arch Otolaryngol Head Neck Surg 2008;134:528–35CrossRefGoogle ScholarPubMed
5Misono, S, Weiss, NS, Fann, JR, Redman, M, Yueh, B. Incidence of suicide in persons with cancer. J Clin Oncol 2008;26:4731–8CrossRefGoogle ScholarPubMed
6Hayden, RE, Mullin, DP, Patel, AK. Reconstruction of the segmental mandibular defect: current state of the art. Curr Opin Otolaryngol Head Neck Surg 2012;20:231–6Google Scholar
7Rogers, SN, Lakshmiah, SR, Narayan, B, Lowe, D, Brownson, P, Brown, JS et al. A comparison of the long-term morbidity following deep circumflex iliac and fibula free flaps for reconstruction following head and neck cancer. Plast Reconstr Surg 2003;112:1517–25; discussion 26–7Google Scholar
8Wehage, IC, Fansa, H. Complex reconstructions in head and neck cancer surgery: decision making. Head Neck Oncol 2011;3:14Google Scholar
9Chim, H, Salgado, CJ, Mardini, S, Chen, HC. Reconstruction of mandibular defects. Semin Plast Surg 2010;24:188–97CrossRefGoogle ScholarPubMed
10Chang, AA, Heskett, KM, Davidson, TM. Searching the literature using medical subject headings versus text word with PubMed. Laryngoscope 2006;116:336–40Google Scholar
11Weymuller, EA, Yueh, B, Deleyiannis, FW, Kuntz, AL, Alsarraf, R, Coltrera, MD. Quality of life in patients with head and neck cancer: lessons learned from 549 prospectively evaluated patients. Arch Otolaryngol Head Neck Surg 2000;126:329–35; discussion 35–6Google Scholar
12Bjordal, K, Ahlner-Elmqvist, M, Hammerlid, E, Boysen, M, Evensen, JF, Biorklund, A et al. A prospective study of quality of life in head and neck cancer patients. Part II: Longitudinal data. Laryngoscope 2001;111:1440–52CrossRefGoogle ScholarPubMed
13Bjordal, K, de Graeff, A, Fayers, PM, Hammerlid, E, van Pottelsberghe, C, Curran, D et al. A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. EORTC Quality of Life Group. Eur J Cancer 2000;36:1796–807Google Scholar
14Zigmond, AS, Snaith, RP. The hospital anxiety and depression scale. Acta Psychiatr Scand 1983;67:361–70CrossRefGoogle ScholarPubMed
15Penfold, CN, Davies, HT, Cole, RP, Evans, BT, Hobby, JA. Combined latissimus dorsi-serratus anterior/rib composite free flap in mandibular reconstruction. Int J Oral Maxillofac Surg 1992;21:92–6CrossRefGoogle ScholarPubMed
16Suh, JD, Blackwell, KE, Sercarz, JA, Cohen, M, Liu, JH, Tang, CG et al. Disease relapse after segmental resection and free flap reconstruction for mandibular osteoradionecrosis. Otolaryngol Head Neck Surg 2010;142:586–91Google Scholar
17Perkins, AJ, Kroenke, K, Unutzer, J, Katon, W, Williams, JW Jr, Hope, C et al. Common comorbidity scales were similar in their ability to predict health care costs and mortality. J Clin Epidemiol 2004;57:1040–8CrossRefGoogle ScholarPubMed
18Papel, ID, Frodel, JL, Holt GR Larrabee, WF, Nachlas, NE, Park, SS et al. Facial plastic and reconstructive surgery, 3rd edn.New York: Thieme, 2009Google Scholar
19Tucker, HM. Nonrigid reconstruction of the mandible. Arch Otolaryngol Head Neck Surg 1989;115:1190–2CrossRefGoogle ScholarPubMed
20Flint, PW, Cummings, CW. Otolaryngology head and neck surgery, 5th edn.St. Louis: Mosby, 2010Google Scholar
21Cannon, TY, Strub, GM, Yawn, RJ, Day, TA. Oromandibular reconstruction. Clin Anat 2012;25:108–19Google Scholar
22Hidalgo, DA. Fibula free flap: a new method of mandible reconstruction. Plast Reconstr Surg 1989;84:71–9Google Scholar
23Goh, BT, Lee, S, Tideman, H, Stoelinga, PJ. Mandibular reconstruction in adults: a review. Int J Oral Maxillofac Surg 2008;37:597–605CrossRefGoogle ScholarPubMed
24Miles, BA, Goldstein, DP, Gilbert, RW, Gullane, PJ. Mandible reconstruction. Curr Opin Otolaryngol Head Neck Surg 2010;18:317–22CrossRefGoogle ScholarPubMed
25Genden, EM. Reconstruction of the mandible and the maxilla: the evolution of surgical technique. Arch Facial Plast Surg 2010;12:87–90CrossRefGoogle ScholarPubMed
26Wolff, K, Hölzle, F. Raising of Microvascular Flaps: A Systematic Approach. Berlin, Heidelberg, New York: Springer, 2011Google Scholar
27Baumann, DP, Yu, P, Hanasono, MM, Skoracki, RJ. Free flap reconstruction of osteoradionecrosis of the mandible: a 10-year review and defect classification. Head Neck 2011;33:800–7Google Scholar
28Deleyiannis, FW, Rogers, C, Ferris, RL, Lai, SY, Kim, S, Johnson, J. Reconstruction of the through-and-through anterior mandibulectomy defect: indications and limitations of the double-skin paddle fibular free flap. Laryngoscope 2008;118:1329–34CrossRefGoogle ScholarPubMed
29Wong, CH, Wei, FC. Microsurgical free flap in head and neck reconstruction. Head Neck 2010;32:1236–45Google Scholar
30Ostrup, LT, Fredrickson, JM. Reconstruction of mandibular defects after radiation, using a free, living bone graft transferred by microvascular anastomose. An experimental study. Plast Reconstr Surg 1975;55:563–72CrossRefGoogle ScholarPubMed
31Seneviratne, S, Duong, C, Taylor, GI. The angular branch of the thoracodorsal artery and its blood supply to the inferior angle of the scapula: an anatomical study. Plast Reconstr Surg 1999;104:85–8Google Scholar
32Yoo, J, Dowthwaite, SA, Fung, K, Franklin, J, Nichols, A. A new angle to mandibular reconstruction: The scapular tip free flap. Head Neck 2012;35:980–6CrossRefGoogle ScholarPubMed
33Kim, JH, Rosenthal, EL, Ellis, T, Wax, MK. Radial forearm osteocutaneous free flap in maxillofacial and oromandibular reconstructions. Laryngoscope 2005;115:1697–701CrossRefGoogle ScholarPubMed
34Soutar, DS, Scheker, LR, Tanner, NS, McGregor, IA. The radial forearm flap: a versatile method for intra-oral reconstruction. Br J Plast Surg 1983;36:1–8CrossRefGoogle ScholarPubMed
35Villaret, DB, Futran, NA. The indications and outcomes in the use of osteocutaneous radial forearm free flap. Head Neck 2003;25:475–81CrossRefGoogle ScholarPubMed
36Cordeiro, PG, Bacilious, N, Schantz, S, Spiro, R. The radial forearm osteocutaneous “sandwich” free flap for reconstruction of the bilateral subtotal maxillectomy defect. Ann Plast Surg 1998;40:397–402CrossRefGoogle ScholarPubMed
37Thoma, A, Allen, M, Tadeson, BH, Archibald, S, Jackson, S, Young, JE. The fate of the osteotomized free radial forearm osteocutaneous flap in mandible reconstruction. J Reconstr Microsurg 1995;11:215–19CrossRefGoogle ScholarPubMed
38Waits, CA, Toby, EB, Girod, DA, Tsue, TT. Osteocutaneous radial forearm free flap: long-term radiographic evaluation of donor site morbidity after prophylactic plating of radius. J Reconstr Microsurg 2007;23:367–72Google Scholar
39Weinzweig, N, Jones, NF, Shestak, KC, Moon, HK, Davies, BW. Oromandibular reconstruction using a keel-shaped modification of the radial forearm osteocutaneous flap. Ann Plast Surg 1994;33:359–69; discussion 69–70Google Scholar
40Flint, PW, Haughey, BH, Lund, VJ, Niparko, JK, Richardson, MA, Robbins, KT et al. Cummings otolaryngology head & neck surgery, 5th edn.Philadelphia: Mosby/Elsevier; 2010Google Scholar
41Urken, ML, Vickery, C, Weinberg, H, Buchbinder, D, Lawson, W, Biller, HF. The internal oblique-iliac crest osseomyocutaneous free flap in oromandibular reconstruction. Report of 20 cases. Arch Otolaryngol Head Neck Surg 1989;115:339–49Google Scholar
42Osoba, D, Rodrigues, G, Myles, J, Zee, B, Pater, J. Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 1998;16:139–44Google Scholar
43Politi, M, Toro, C. Iliac flap versus fibula flap in mandibular reconstruction. J Craniofac Surg 2012;23:774–9Google Scholar
44De Graeff, A, De Leeuw, JR, Ros, WJ, Hordijk, GJ, Blijham, GH, Winnubst, JA. Pretreatment factors predicting quality of life after treatment for head and neck cancer. Head Neck 2000;22:398–407Google Scholar