Objective: To assess the effectiveness and reliability of free flap transfer for treating the advanced osteoradionecrosis (ORN) of mandible.
Methods: Eleven cases of free flap transfer for treating the advanced ORN of mandible from October 1999 to February 2003 were reviewed. Data concerning the operation included site, stage and histology of primary tumor, dosage of radiotherapy, defect description, design of free flap, recipient vessel, free flap survival and complications.
Results: There were 8 males and 3 females, with age ranged 29-65 years old. Fifteen free flaps were used for reconstructing the defects, 12 were fibula flap, 2 were rectus abdominis myocutaneous flap, and 1 was radial forearm flap. All the free flaps survived completely without partial or total necrosis. The complication rate was 36.4%. All patients had complete resolution of ORN symptoms. No evidence of ORN recurrence was observed in any patient.
Conclusion: Free flap transfer provides a reliable and effective means for treating the advanced ORN of mandible. Free fibula flap is the workhorse flap for reconstruction of mandible.