MANDIBULAR RECONSTRUCTION WITH METAL PLATE AND MYOCUTANEOUS FLAP

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Abstract
The combination of myocutaneous flap with three dimensional, bendable reconstruction plate has provided very satisfactory results in restoration of mandibular defects following surgical resections in irradiated patients. Twenty–four cases have been treated and evaluated prospectively using this technique. Patients requiring postoperative irradiation were excluded from this study. Two groups were identified. Group A (n=20) required myocutaneous flap to resurface the soft tissue defect and Group B (n=4) were treated by primary closure. No failures were encountered in the group handled primarily with myocutaneous flap combined with an AO plate. One failure occurred in the group closed primarily. Nine (38%) of the patients have maintained their plate for over 1 year. Twelve (55%) have functioned for more than 9 months. Of the remaining three (7%), one failed and the other two have been in place for more than 5 months. The results of this study demonstrate that well–vascularized soft tissue bed in combination with stainless steel plate provides very satisfactory, functional, esthetic and reliable method in rehabilitation of mandibular defects primarily in irradiated patients.