Prevention points for plate exposure in the mandibular reconstruction

Satoshi Onoda, Yoshihiro Kimata, Kiyoshi Yamada, Narushi Sugiyama, Tomoo Onoda, Motoharu Eguchi, Nobuyoshi Mizukawa

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Introduction: The rate of complications for mandibular reconstruction after segmental mandibulectomy is higher with reconstruction plates than with vascularised bone grafts. We have experience of over 100 patients using reconstructive plates for reconstruction immediately after segmental mandibulectomy and have considered factors contributing to plate exposure. Patients and methods: Seventeen cases utilised our prevention methods in which reconstructive plates were used for mandibular reconstruction were reviewed. The flaps used with reconstruction plates were rectus abdominis myocutanenous flaps in 10 cases, anterolateral thigh flaps combined vastus lateralis muscle in four cases, and the omentum in one case; no flap was transferred in two cases. Results: In only one of 17 cases was a plate exposed at 3 months postoperatively. No plate exposure occurred during the follow-up period in the other 16 cases. Because no flap had been transferred in the patient with plate exposure, a possible contributing factor was the persistence of dead space beneath the plate. Conclusion: This series suggests that factors other than flap selection contribute to the exposure of reconstructive plates. Use of a reconstruction plate is a useful reconstructive method, especially for patients who cannot tolerate transfer of a vascularised bone graft.

Original languageEnglish
JournalJournal of Cranio-Maxillofacial Surgery
Volume40
Issue number8
DOIs
Publication statusPublished - Dec 2012

Fingerprint

Mandibular Reconstruction
Mandibular Osteotomy
Transplants
Bone and Bones
Rectus Abdominis
Omentum
Quadriceps Muscle
Thigh
Muscles

Keywords

  • Complication
  • Mandibular reconstruction
  • Preventing plate exposure
  • Reconstruction plate
  • Vascularised bone grafts

ASJC Scopus subject areas

  • Oral Surgery
  • Otorhinolaryngology
  • Surgery

Cite this

Prevention points for plate exposure in the mandibular reconstruction. / Onoda, Satoshi; Kimata, Yoshihiro; Yamada, Kiyoshi; Sugiyama, Narushi; Onoda, Tomoo; Eguchi, Motoharu; Mizukawa, Nobuyoshi.

In: Journal of Cranio-Maxillofacial Surgery, Vol. 40, No. 8, 12.2012.

Research output: Contribution to journalArticle

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AU - Yamada, Kiyoshi

AU - Sugiyama, Narushi

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AU - Eguchi, Motoharu

AU - Mizukawa, Nobuyoshi

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N2 - Introduction: The rate of complications for mandibular reconstruction after segmental mandibulectomy is higher with reconstruction plates than with vascularised bone grafts. We have experience of over 100 patients using reconstructive plates for reconstruction immediately after segmental mandibulectomy and have considered factors contributing to plate exposure. Patients and methods: Seventeen cases utilised our prevention methods in which reconstructive plates were used for mandibular reconstruction were reviewed. The flaps used with reconstruction plates were rectus abdominis myocutanenous flaps in 10 cases, anterolateral thigh flaps combined vastus lateralis muscle in four cases, and the omentum in one case; no flap was transferred in two cases. Results: In only one of 17 cases was a plate exposed at 3 months postoperatively. No plate exposure occurred during the follow-up period in the other 16 cases. Because no flap had been transferred in the patient with plate exposure, a possible contributing factor was the persistence of dead space beneath the plate. Conclusion: This series suggests that factors other than flap selection contribute to the exposure of reconstructive plates. Use of a reconstruction plate is a useful reconstructive method, especially for patients who cannot tolerate transfer of a vascularised bone graft.

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