Managing Oromandibular Hardware Failure after Free Flap Surgery

Abstract

Hardware failure after oromandibular reconstruction using free tissue transfer can delay additional therapies directed at cancer treatment and prevent patients from returning to normal oral function. Understanding and strict adherence to principles of rigid fixation is critical in preventing complications. Early surgical intervention for hardware exposure as well as utilization of locoregional flaps may prevent the need for more extensive revision surgery.

Keywords

hardware failure - free flap - free tissue transfer - surgical complications

Publikationsverlauf

Artikel online veröffentlicht:
30. Dezember 2022

• References

• 1 Bauer E, Mazul A, Zenga J. et al. Complications after soft tissue with plate vs bony mandibular reconstruction: a systematic review and meta-analysis. Otolaryngol Head Neck Surg 2021; 164 (03) 501-511
• 2 Fanzio PM, Chang KP, Chen HH. et al. Plate exposure after anterolateral thigh free-flap reconstruction in head and neck cancer patients with composite mandibular defects. Ann Surg Oncol 2015; 22 (09) 3055-3060
• 3 Wei F-C, Celik N, Yang WG, Chen IH, Chang YM, Chen HC. Complications after reconstruction by plate and soft-tissue free flap in composite mandibular defects and secondary salvage reconstruction with osteocutaneous flap. Plast Reconstr Surg 2003; 112 (01) 37-42
• 4 Prasad J, Sahovaler A, Theurer J. et al. Predictors of plate extrusion in oromandibular free flap reconstruction. Microsurgery 2018; 38 (06) 682-689
• 5 Day KE, Desmond R, Magnuson JS, Carroll WR, Rosenthal EL. Hardware removal after osseous free flap reconstruction. Otolaryngol Head Neck Surg 2014; 150 (01) 40-46
• 6 Knott PD, Suh JD, Nabili V. et al. Evaluation of hardware-related complications in vascularized bone grafts with locking mandibular reconstruction plate fixation. Arch Otolaryngol Head Neck Surg 2007; 133 (12) 1302-1306
• 7 Nicholson RE, Schuller DE, Forrest LA, Mountain RE, Ali T, Young D. Factors involved in long- and short-term mandibular plate exposure. Arch Otolaryngol Head Neck Surg 1997; 123 (02) 217-222
• 8 Coletti DP, Ord R, Liu X. Mandibular reconstruction and second generation locking reconstruction plates: outcome of 110 patients. Int J Oral Maxillofac Implants 2009; 38 (09) 960-963
• 9 Liu S-P, Cai Z-G, Zhang J, Zhang J-G, Zhang Y. Stability and complications of miniplates for mandibular reconstruction with a fibular graft: outcomes for 544 patients. Br J Oral Maxillofac Surg 2016; 54 (05) 496-500
• 10 Farwell DG, Kezirian EJ, Heydt JL, Yueh B, Futran ND. Efficacy of small reconstruction plates in vascularized bone graft mandibular reconstruction. Head Neck 2006; 28 (07) 573-579
• 11 Gutwald R, Alpert B, Schmelzeisen R. Principle and stability of locking plates. Keio J Med 2003; 52 (01) 21-24
• 12 Ellis III E, Graham J. Use of a 2.0-mm locking plate/screw system for mandibular fracture surgery. J Oral Maxillofac Surg 2002; 60 (06) 642-645 , discussion 645–646
• 13 Chang T-Y, Lai YS, Lin CY. et al. Plate-related complication and health-related quality of life after mandibular reconstruction by fibula flap with reconstruction plate or miniplate versus anterolateral thigh flap with reconstruction plate. Microsurgery 2022;
• 14 Zavattero E, Fasolis M, Garzino-Demo P, Berrone S, Ramieri GA. Evaluation of plate-related complications and efficacy in fibula free flap mandibular reconstruction. J Craniofac Surg 2014; 25 (02) 397-399
• 15 Shaw RJ, Kanatas AN, Lowe D, Brown JS, Rogers SN, Vaughan ED. Comparison of miniplates and reconstruction plates in mandibular reconstruction. Head Neck 2004; 26 (05) 456-463
• 16 McCann AC, Shnayder Y, Przylecki WH. et al. Comparison of modern rigid fixation plating outcomes for segmental mandibular microvascular reconstruction. Laryngoscope 2019; 129 (05) 1081-1086
• 17 Davies JC, Chan HHL, Yao CMKL. et al. Association of plate contouring with hardware complications following mandibular reconstruction. Laryngoscope 2022; 132 (01) 61-66
• 18 Tarsitano A, Ciocca L, Scotti R, Marchetti C. Morphological results of customized microvascular mandibular reconstruction: a comparative study. J Craniomaxillofac Surg 2016; 44 (06) 697-702
• 19 Wilde F, Hanken H, Probst F, Schramm A, Heiland M, Cornelius CP. Multicenter study on the use of patient-specific CAD/CAM reconstruction plates for mandibular reconstruction. Int J CARS 2015; 10 (12) 2035-2051
• 20 Haddock NT, Monaco C, Weimer KA, Hirsch DL, Levine JP, Saadeh PB. Increasing bony contact and overlap with computer-designed offset cuts in free fibula mandible reconstruction. J Craniofac Surg 2012; 23 (06) 1592-1595
• 21 Tang NSJ, Ahmadi I, Ramakrishnan A. Virtual surgical planning in fibula free flap head and neck reconstruction: a systematic review and meta-analysis. J Plast Reconstr Aesthetic Surg 2019; 72 (09) 1465-1477
• 22 Wood CB, Shinn JR, Amin SN, Rohde SL, Sinard RJ. Risk of plate removal in free flap reconstruction of the mandible. Oral Oncol 2018; 83: 91-95