Sequential free fibula transfers: Quality of life and systematic review.
Journal
Microsurgery
ISSN: 1098-2752
Titre abrégé: Microsurgery
Pays: United States
ID NLM: 8309230
Informations de publication
Date de publication:
May 2024
May 2024
Historique:
revised:
04
03
2024
received:
28
11
2023
accepted:
26
04
2024
medline:
15
5
2024
pubmed:
15
5
2024
entrez:
15
5
2024
Statut:
ppublish
Résumé
Successive osteoseptocutaneous fibula transfers for jaws reconstruction are rare but important options. This study contributes patient-reported and clinical outcomes, as well as systematically reviews all existing reports. All sequential fibula transfers performed by the senior author were reviewed from a prospectively managed database, including University of Washington quality of life (UWQoL). Systematic review was conducted in PubMed and Cochrane databases for similar publications. Eighteen patients (average age 51.5 years) received sequential fibulas (mean 4.7 years between reconstructions). Secondary fibulas more often had benign indications (72.2% vs. 33.3%, p = .04), most commonly osteoradionecrosis (38.9%). At a mean follow-up of 30.5 months, the average interincisal distance increased from 21.8 to 27.6 mm, and 92.3% tolerated an oral diet following the second fibula. Eight patients completed the UW-QoL before and after the second fibula, and three prior to the first fibula. Composite physical function was significantly decreased from 96.7 prefibula reconstruction to 63.3 following the first (p < .001) and 64.2 after the second fibula (p < .001). There were no differences in other domains. The systematic review yielded six articles reporting 56 patients (mean 39 months between fibulas). Secondary fibulas were performed for repeat malignancy (45%) and osteoreadionecrosis (39%), resulting in elevated tube feeding from 20% following the first to 39% following the second, but overall high quality of life in two studies. Sequential osteoseptocutaneous fibula reconstructions of jaws are often performed for benign indications such as osteoradionecrosis. Overall function and QoL are comparable with those following the first fibula transfer.
Sections du résumé
BACKGROUND
BACKGROUND
Successive osteoseptocutaneous fibula transfers for jaws reconstruction are rare but important options. This study contributes patient-reported and clinical outcomes, as well as systematically reviews all existing reports.
METHODS
METHODS
All sequential fibula transfers performed by the senior author were reviewed from a prospectively managed database, including University of Washington quality of life (UWQoL). Systematic review was conducted in PubMed and Cochrane databases for similar publications.
RESULTS
RESULTS
Eighteen patients (average age 51.5 years) received sequential fibulas (mean 4.7 years between reconstructions). Secondary fibulas more often had benign indications (72.2% vs. 33.3%, p = .04), most commonly osteoradionecrosis (38.9%). At a mean follow-up of 30.5 months, the average interincisal distance increased from 21.8 to 27.6 mm, and 92.3% tolerated an oral diet following the second fibula. Eight patients completed the UW-QoL before and after the second fibula, and three prior to the first fibula. Composite physical function was significantly decreased from 96.7 prefibula reconstruction to 63.3 following the first (p < .001) and 64.2 after the second fibula (p < .001). There were no differences in other domains. The systematic review yielded six articles reporting 56 patients (mean 39 months between fibulas). Secondary fibulas were performed for repeat malignancy (45%) and osteoreadionecrosis (39%), resulting in elevated tube feeding from 20% following the first to 39% following the second, but overall high quality of life in two studies.
CONCLUSIONS
CONCLUSIONS
Sequential osteoseptocutaneous fibula reconstructions of jaws are often performed for benign indications such as osteoradionecrosis. Overall function and QoL are comparable with those following the first fibula transfer.
Types de publication
Systematic Review
Journal Article
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e31184Informations de copyright
© 2024 Wiley Periodicals LLC.
Références
Adeel, M., & Siddiqi, M. I. (2018). Metachronous second primary malignancy in head and neck cancer patients: Is five years of follow‐up sufficient? Journal of the Korean Association of Oral and Maxillofacial Surgeons, 44, 220–224.
Awad, M. E., Altman, A., Elrefai, R., Shipman, P., Looney, S., & Elsalanty, M. (2019). The use of vascularized fibula flap in mandibular reconstruction; a comprehensive systematic review and meta‐analysis of the observational studies. Journal of Cranio‐Maxillofacial Surgery, 47, 629–641.
Boyd, J. B., Gullane, P. J., Rotstein, L. E., Brown, D. H., & Irish, J. C. (1993). Classification of mandibular defects. Plastic and Reconstructive Surgery, 92(7), 1266–1275.
Bugter, O., van Iwaarden, D. L. P., Dronkers, E. A. C., de Herdt, M. J., Wieringa, M. H., Verduijn, G. M., Mureau, M. A. M., ten Hove, I., van Meerten, E., Hardillo, J. A., & Baatenburg de Jong, R. J. (2019). Survival of patients with head and neck cancer with metachronous multiple primary tumors is surprisingly favorable. Head & Neck, 41, 1648–1655.
Deek, N. F. A., & Wei, F.‐C. (2016). Computer‐assisted surgery for segmental mandibular reconstruction with the osteoseptocutaneous fibula flap: Can we instigate ideological and technological reforms? Plastic and Reconstructive Surgery, 137, 963–970.
Du, E., Mazul, A. L., Farquhar, D., Brennan, P., Anantharaman, D., Abedi‐Ardekani, B., Weissler, M. C., Hayes, D. N., Olshan, A. F., & Zevallos, J. P. (2019). Long‐term survival in head and neck cancer: Impact of site, stage, smoking, and human papillomavirus status. The Laryngoscope, 129, 2506–2513.
Ferrari, S., Perlangeli, G., Mammi, P., Varazzani, A., Bianchi, B., Fusetti, S., Brevi, B. C., & Ferri, A. (2018). Bilateral harvesting of a fibula free flap: Assessment of morbidity. The Journal of Craniofacial Surgery, 29, 2131–2134.
Gao, N., Fu, K., & He, W. (2018). Assessment of the quality of life of mandible defect after reconstruction with fibula flap. Zhonghua kou Qiang Yi Xue Za Zhi = Zhonghua Kouqiang Yixue Zazhi = Chinese Journal of Stomatology, 53, 408–412.
Gu, Y., Ma, H., Shujaat, S., Orhan, K., Coucke, W., Amoli, M. S., Bila, M., Politis, C., & Jacobs, R. (2021). Donor‐and recipient‐site morbidity of vascularized fibular and iliac flaps for mandibular reconstruction: A systematic review and meta‐analysis. Journal of Plastic, Reconstructive & Aesthetic Surgery, 74, 1470–1479.
Hanasono, M. M., Corbitt, C. A., Yu, P., & Skoracki, R. J. (2014). Success of sequential free flaps in head and neck reconstruction. Journal of Plastic, Reconstructive & Aesthetic Surgery, 67, 1186–1193.
Ho, A. S., Kraus, D. H., Ganly, I., Lee, N. Y., Shah, J. P., & Morris, L. G. T. (2014). Decision making in the management of recurrent head and neck cancer. Head & Neck, 36, 144–151.
Kim, J.‐W., Hwang, J.‐H., & Ahn, K.‐M. (2016). Fibular flap for mandible reconstruction in osteoradionecrosis of the jaw: Selection criteria of fibula flap. Maxillofacial Plastic and Reconstructive Surgery, 38, 1–7.
Lin, J.‐Y., Djohan, R., Dobryansky, M., Chou, S. W., Hou, W. H., Chen, M. H., & Wei, F. C. (2009). Assessment of donor‐site morbidity using balance and gait tests after bilateral fibula osteoseptocutaneous free flap transfer. Annals of Plastic Surgery, 62, 246–251.
Ling, X. F., & Peng, X. (2012). What is the price to pay for a free fibula flap? A systematic review of donor‐site morbidity following free fibula flap surgery. Plastic and Reconstructive Surgery, 129, 657–674.
Loh, C. Y. Y., Tsai, C.‐H., Chang, K.‐P., Wu, J. C.‐H., & Kao, H.‐K. (2019). Free flap outcomes of microvascular reconstruction after repeated segmental mandibulectomy in head and neck cancer patients. Scientific Reports, 9, 1–7.
López‐Arcas, J. M., Arias, J., del Castillo, J. L., Burgueño, M., Navarro, I., Morán, M. J., Chamorro, M., & Martorell, V. (2010). The fibula osteomyocutaneous flap for mandible reconstruction: A 15‐year experience. Journal of Oral and Maxillofacial Surgery, 68, 2377–2384.
Mahal, B. A., Catalano, P. J., Haddad, R. I., Hanna, G. J., Kass, J. I., Schoenfeld, J. D., Tishler, R. B., & Margalit, D. N. (2019). Incidence and demographic burden of HPV‐associated oropharyngeal head and neck cancers in the United States. Cancer Epidemiology, Biomarkers & Prevention, 28, 1660–1667.
Matros, E., Schwarz, G. S., Mehrara, B. J., Hu, Q. Y., Cordeiro, P. G., & Disa, J. J. (2010). Indications and outcomes for mandibular reconstruction using sequential bilateral fibula flaps. Plastic and Reconstructive Surgery, 126, 1539–1547.
Mericli, A. F., Schaverien, M. V., Hanasono, M. M., Yu, P., Largo, R. D., Villa, M. T., Reece, G., Butler, C. E., & Garvey, P. B. (2017). Using a second free fibula osteocutaneous flap after repeated mandibulectomy is associated with a low complication rate and acceptable functional outcomes. Plastic and Reconstructive Surgery, 140, 381–389.
Moratin, J., Horn, D., Heinemann, M., Metzger, K., Mrosek, J., Ristow, O., Engel, M., Freudlsperger, C., Freier, K., & Hoffmann, J. (2021). Multiple sequential free flap reconstructions of the head and neck: A single‐center experience. Plastic and Reconstructive Surgery, 148, 791e–799e.
Nabil, S., & Samman, N. (2012). Risk factors for osteoradionecrosis after head and neck radiation: A systematic review. Oral Radiology, 113, 54–69.
Ni, Y., Zhang, X., Zhang, Z., Liang, W., Zhao, L., Li, Z., Li, S., Lu, P., Xu, Z., Dai, W., Duan, W., Tan, X., Sun, C., & Liu, F. (2020). Assessment of fibula flap with flexor hallucis longus's effect on head & neck tumor patients' quality of life and function of donor site. Oral Oncology, 100, 104489.
Nisanc, M., Türegün, M., Er, E., & Sengezer, M. (2003). Reconstruction of the middle and lower face with three simultaneous free flaps: Combined use of bilateral fibular flaps for maxillomandibular reconstruction. Annals of Plastic Surgery, 51, 301–307.
Santos, W. M. d., Secoli, S. R., & Püschel, V. A. d. A. (2018). The Joanna Briggs Institute approach for systematic reviews. Revista Latino‐Americana de Enfermagem, 26, e3074.
Sassu, P., Acland, R. D., Salgado, C. J., Mardini, S., & Ozyurekoglu, T. (2010). Anatomy and vascularization of the flexor hallucis longus muscle and its implication in free fibula flap transfer: An anatomical study. Annals of Plastic Surgery, 64, 233–237.
Su, S.‐Y., Chen, W.‐T., Chiang, C.‐J., Yang, Y.‐W., & Lee, W.‐C. (2020). Oral cancer incidence rates from 1997 to 2016 among men in Taiwan: Association between birth cohort trends and betel nut consumption. Oral Oncology, 107, 104798.
Tiwana, M. S., Hay, J., Wu, J., Wong, F., Cheung, W., & Olson, R. A. (2014). Incidence of second metachronous head and neck cancers: Population‐based outcomes over 25 years. The Laryngoscope, 124, 2287–2291.
Toneatti, D. J., Graf, R. R., Burkhard, J.‐P., & Schaller, B. (2021). Survival of dental implants and occurrence of osteoradionecrosis in irradiated head and neck cancer patients: A systematic review and meta‐analysis. Clinical Oral Investigations, 25, 5579–5593.
van den Heuvel, S. C., van der Veen, F. J., & Winters, H. A. (2014). The effect of flexor hallucis longus harvest on hallux function: A retrospective cross‐sectional cohort study. Journal of Plastic, Reconstructive & Aesthetic Surgery, 67, 986–991.
van Imhoff, L. C. R., Kranenburg, G. G. J., Macco, S., Nijman, N. L., van Overbeeke, E. J., Wegner, I., Grolman, W., & Pothen, A. J. (2016). Prognostic value of continued smoking on survival and recurrence rates in patients with head and neck cancer: A systematic review. Head & Neck, 38, E2214–E2220.
Wang, C.‐P., Chen, T.‐C., Hsu, W.‐L., Hsiao, J.‐R., Chen, P.‐R., Chen, M.‐K., Hua, C.‐H., Tsai, M.‐H., Ko, J.‐Y., Lou, P.‐J., Chiang, C.‐J., Wu, C.‐T., & Chang, Y.‐L. (2022). Rising incidence of HPV positive oropharyngeal cancer in Taiwan between 1999 and 2014 where betel nut chewing is common. BMC Cancer, 22, 1–10.
Wei, F.‐C., Chen, H.‐C., Chuang, C.‐C., & Noordhoff, M. S. (1986). Fibular osteoseptocutaneous flap: Anatomic study and clinical application. Plastic and Reconstructive Surgery, 78, 191–199.
Wei, F.‐C., Santamaria, E., Chang, Y.‐M., & Chen, H.‐C. (1997). Mandibular reconstruction with fibular osteoseptocutaneous free flap and simultaneous placement of osseointegrated dental implants. The Journal of Craniofacial Surgery, 8, 512–521.
Wei, F.‐C., Seah, C.‐S., Tsai, Y.‐C., Liu, S.‐J., & Tsai, M.‐S. (1994). Fibula osteoseptocutaneous flap for reconstruction of composite mandibular defects. Plastic and Reconstructive Surgery, 93, 294–304.
Weymuller, E. A., Jr., Alsarraf, R., Yueh, B., Deleyiannis, F. W.‐B., & Coltrera, M. D. (2001). Analysis of the performance characteristics of the University of Washington quality of life instrument and its modification (UW‐QOL‐R). Archives of Otolaryngology—Head and Neck Surgery, 127, 489–493.
Wood, C. B., Ha, A. Y., Puram, S. V., Jackson, R. S., & Pipkorn, P. (2022). The two‐handed template for planning fibular free flap reconstruction of the head and neck. Head & Neck, 44, 296–299.
Yang, W., Zhao, S., Liu, F., & Sun, M. (2014). Health‐related quality of life after mandibular resection for oral cancer: Reconstruction with free fibula flap. Medicina Oral, Patologia Oral Y Cirugia Bucal, 19, e414–e418.