Retrospective Study on 90 Cases of Mandibular Defects Repaired with Fibular Flap with Different Thicknesses of Reconstruction Titanium Plates

doi:10.13701/j.cnki.kqyxyj.2025.05.005

Abstract

Abstract: Objective: To investigate the effect of different thickness of reconstruction titanium plate on the clinical results of reconstruction of mandibular defects with fibular flap. Methods: A retrospective analysis was conducted on the clinical information and follow-up records of patients with mandibular defects caused by malignant tumors admitted to the First Ward of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital from January 2018 to June 2024 and repaired with fibular musculocutaneous flaps at the same time. Results: A total of 90 patients with complete follow-up information were included. Postoperative complications occurred in 9 patients with a median time of 9 months. On univariate analysis, postoperative radiotherapy (P<0.002) was significantly associated with postoperative complications. Multivariate analysis showed that postoperative radiotherapy (P=0.015) was an independent risk factor for postoperative complications. A total of 19 patients received postoperative radiotherapy, including 12 patients in the sub-reconstruction titanium plate group (thickness 2.0 mm). The incidence of long-term complications was 8.3% (1/12). There were 7 patients in the reconstruction plate group (thickness≥2.5 mm), and the incidence of long-term complications was 71.4% (5/7). There was significant difference between the two groups (P=0.019). Conclusion: Postoperative radiotherapy can significantly increase the incidence of complications after mandibular defect reconstruction with fibular flap. Close follow-up is necessary for 6-18 months after surgery. The use of different thickness reconstruction titanium plates has no significant effect on the occurrence of postoperative complications in patients with mandibular defects repaired with fibular flap. However, for patients who are expected to undergo postoperative radiotherapy, the use of sub-reconstruction titanium plates should be tried to reduce the incidence of postoperative complications.

Key words: fibular flap, mandibular reconstruction, reconstruction titanium plate, complications, radiation therapy

SUN Yawei, WU Zhuhao, CHEN Xin, PU Yumei, SUN Guowen. Retrospective Study on 90 Cases of Mandibular Defects Repaired with Fibular Flap with Different Thicknesses of Reconstruction Titanium Plates[J]. Journal of Oral Science Research, 2025, 41(5): 386-390.

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