Objective: Treatment of mandibular osteoradionecrosis is always a therapeutic challenge. The aim of this article is to evaluate the interest of fibula free flap for mandible reconstruction after radical excision of osteoradionecrotic lesions.
Material and methods: Six consecutives cases of extensive osteoradionecrosis of the mandible were treated with fibula free flap reconstruction. We report a meticulous analysis of the cosmetic and functional results.
Results: All vascularized fibula osteocutaneous flaps transplanted were successful. Median hospital stay was 32 days. At 6 months, functional results (swallowing, mouth opening and speech) were good. All patients had sufficient oral intake and a comprehensible speech with just two patients requiring a soft diet and 1 patient retaining a moderate trismus.
Discussion: Extensive mandibular osteoradionecrosis requires a radical surgical treatment. Fibula free flap is the best solution for mandible reconstruction in this situation. This technique allows good functional results.
Conclusion: Fibula free flap is the method of choice for mandible reconstruction after radical treatment of osteoradionecrosis.