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[Fibular free-flap for mandibular reconstruction in patients undergoing mandibulectomy for oral cavity and bone tumors: 10-year experience].

BACKGROUND
Fibular-free-flap is currently considered the optimum choice in mandible reconstruction.


OBJECTIVE
Assess our results using this technique after 10 years-experience.


MATERIAL AND METHODS
Patients underwent mandibulectomy and primary or secondary reconstruction with fibular-free-flap between 1995 and 2005. Variables analyzed included: surgical time, time of micro-vascular anastomosis, bleeding, tobacco history, comorbidity, chemo-radiotherapy background, flap type and primary or secondary reconstruction.


RESULTS
We included, 60 patients and performed 62 flaps. We included 27 women and 33 men; mean age was 43 years, 30 had malignant tumors and 30 benign. Diabetes was the most frequent co-morbid pathology. In 49 subjects reconstruction was primary and secondary in 11; in 38 the flap was osseous and in 22 osteocutaneous. In 52 patients (87%) the flap was successful and 8 showed total loss. The most frequent complications were osteosynthesis material exposure, pseudoarthrosis and cervical abscess. Four patients were subjected to re-exploration but the flap was preserved in all. No acssociation was found among any of the variables studied and flap viability. The functional result was considered adequate in 90% of cases and was associated with time of reconstruction.


CONCLUSION
Fibular-free-flap is a safe alternative in mandible reconstruction. Primary reconstruction offers better functional results.