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Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study

The objective of this study was to analyze the outcomes of the free vascularized fibular flap in the reconstruction of mandibular defects, and to assess the oral health impact profile of these patients before surgery and after oral rehabilitation. Patients requiring reconstruction of defects greater...

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Autores principales: Qayyum, Zahid, Khan, Zafar Ali, Maqsood, Afsheen, Prabhu, Namdeo, Saad Alqarni, Mohammed, Bader, Alzarea K., Issrani, Rakhi, Abbasi, Maria Shakoor, Ahmed, Naseer, Sghaireen, Mohammed Ghazi, Heboyan, Artak
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859578/
https://www.ncbi.nlm.nih.gov/pubmed/36673561
http://dx.doi.org/10.3390/healthcare11020193
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author Qayyum, Zahid
Khan, Zafar Ali
Maqsood, Afsheen
Prabhu, Namdeo
Saad Alqarni, Mohammed
Bader, Alzarea K.
Issrani, Rakhi
Abbasi, Maria Shakoor
Ahmed, Naseer
Sghaireen, Mohammed Ghazi
Heboyan, Artak
author_facet Qayyum, Zahid
Khan, Zafar Ali
Maqsood, Afsheen
Prabhu, Namdeo
Saad Alqarni, Mohammed
Bader, Alzarea K.
Issrani, Rakhi
Abbasi, Maria Shakoor
Ahmed, Naseer
Sghaireen, Mohammed Ghazi
Heboyan, Artak
author_sort Qayyum, Zahid
collection PubMed
description The objective of this study was to analyze the outcomes of the free vascularized fibular flap in the reconstruction of mandibular defects, and to assess the oral health impact profile of these patients before surgery and after oral rehabilitation. Patients requiring reconstruction of defects greater than 6 cm were selected for this study. The defect size and type, the size of the required skin paddle, the need for second flaps, the intraoperative complications, and the type of closure were documented. Patients were evaluated postoperatively for function, aesthetics, and donor- or reconstruction-site complications. The validated oral health impact profile (OHIP-14) questionnaires were filled before and after surgery and after dental rehabilitation. This study included 11 cases of squamous-cell carcinomas, 2 cases of malignant nerve sheath tumors, and 1 case each of malignant melanoma, ameloblastoma, giant-cell tumor, osteosarcoma, and chondrosarcoma. The analysis revealed a significant association (p = 0.030) of gender with free vascular flap complications, while no significant association (p > 0.05) was found when donor- and recipient- site complications, as well as the type of resection (Brown’s classification), were compared with free vascular flaps. Moreover, the total OHIP-14 scores for patients before surgery, after surgery, and after dental rehabilitation were 12.03 ± 1.34, 10.66 ± 1.41, and 08.33 ± 0.62, respectively. The oral health-related quality of life was markedly improved after the reconstruction of the mandibular defects with free vascularized fibular flap and dental rehabilitation. The overall success rate of fibular flap in our study was 72.2%, which is lower than that reported in the literature. This may be attributed to the fact that almost all of our cases included large segmental defects that extended across the midline of the mandible.
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spelling pubmed-98595782023-01-21 Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study Qayyum, Zahid Khan, Zafar Ali Maqsood, Afsheen Prabhu, Namdeo Saad Alqarni, Mohammed Bader, Alzarea K. Issrani, Rakhi Abbasi, Maria Shakoor Ahmed, Naseer Sghaireen, Mohammed Ghazi Heboyan, Artak Healthcare (Basel) Article The objective of this study was to analyze the outcomes of the free vascularized fibular flap in the reconstruction of mandibular defects, and to assess the oral health impact profile of these patients before surgery and after oral rehabilitation. Patients requiring reconstruction of defects greater than 6 cm were selected for this study. The defect size and type, the size of the required skin paddle, the need for second flaps, the intraoperative complications, and the type of closure were documented. Patients were evaluated postoperatively for function, aesthetics, and donor- or reconstruction-site complications. The validated oral health impact profile (OHIP-14) questionnaires were filled before and after surgery and after dental rehabilitation. This study included 11 cases of squamous-cell carcinomas, 2 cases of malignant nerve sheath tumors, and 1 case each of malignant melanoma, ameloblastoma, giant-cell tumor, osteosarcoma, and chondrosarcoma. The analysis revealed a significant association (p = 0.030) of gender with free vascular flap complications, while no significant association (p > 0.05) was found when donor- and recipient- site complications, as well as the type of resection (Brown’s classification), were compared with free vascular flaps. Moreover, the total OHIP-14 scores for patients before surgery, after surgery, and after dental rehabilitation were 12.03 ± 1.34, 10.66 ± 1.41, and 08.33 ± 0.62, respectively. The oral health-related quality of life was markedly improved after the reconstruction of the mandibular defects with free vascularized fibular flap and dental rehabilitation. The overall success rate of fibular flap in our study was 72.2%, which is lower than that reported in the literature. This may be attributed to the fact that almost all of our cases included large segmental defects that extended across the midline of the mandible. MDPI 2023-01-09 /pmc/articles/PMC9859578/ /pubmed/36673561 http://dx.doi.org/10.3390/healthcare11020193 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Qayyum, Zahid
Khan, Zafar Ali
Maqsood, Afsheen
Prabhu, Namdeo
Saad Alqarni, Mohammed
Bader, Alzarea K.
Issrani, Rakhi
Abbasi, Maria Shakoor
Ahmed, Naseer
Sghaireen, Mohammed Ghazi
Heboyan, Artak
Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study
title Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study
title_full Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study
title_fullStr Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study
title_full_unstemmed Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study
title_short Outcome Assessment after Reconstruction of Tumor-Related Mandibular Defects Using Free Vascularized Fibular Flap—A Clinical Study
title_sort outcome assessment after reconstruction of tumor-related mandibular defects using free vascularized fibular flap—a clinical study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9859578/
https://www.ncbi.nlm.nih.gov/pubmed/36673561
http://dx.doi.org/10.3390/healthcare11020193
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