Introduction: The reconstruction of mandibular continuity destroyed by osteoradionecrosis can be a difficult task. The aim of this study was to evaluate the reliability and contribution of vascular osseous flaps for mandibular reconstruction after osteoradionecrosis.
Material and method: A retrospective study of patients undergoing mandibular reconstruction after osteoradionecrosis between 1989 and 2002 was performed. Twenty-five mandibular reconstructions were performed in 23 patients: 16 fibular free flaps, 5 osteomuscular serrato-costal free flaps, 1 osteocutaneous external brachial free flap, 1 medial femoral condylar free flap and 2 armed pectoralis major pediculed flaps.
Results: We observed two major complications (8%): loss of one fibular flap and one medial femoral condylar free flap. We observed 42% minor complications. Overall quality of life was constantly enhanced.
Discussion: Fibular flap is definitely a good method for immediate or secondary mandibular reconstruction. A serratocostal flap must be considered as an alternative flap when the fibular flap is unavailable.