Fibula flap reconstruction for maxillary stage 3 medication-related osteonecrosis of the jaw from recipient and donor site perspectives: a preliminary single-center study.

IF 2.6 2区 医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE
Yuhan Lin, Jin Wang, Yongzhen Lai, Chuanqing Mao, Meng Lu, Chengyong Wang, Qiming Ouyang, Yue He, Weihui Chen
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Abstract

Background: While the surgical treatment of mandibular stage 3 medication-related osteonecrosis of the jaw (MRONJ) is well-documented, research on maxillary stage 3 MRONJ is limited. Antiresorptive medications can induce MRONJ and atypical femoral fracture (AFF), but their impact on the feasibility of using fibula flaps for reconstruction remains controversial. This study aimed to assess the surgical outcomes and functional recovery of fibula flap reconstruction for maxillary stage 3 MRONJ, considering both recipient and donor site outcomes.

Methods: This retrospective study included patients with maxillary stage 3 MRONJ who underwent fibula flap reconstruction. Demographic and clinical features, postoperative complications, long-term outcomes and functional recovery of both recipient and donor sites were analyzed. Long-term outcomes included the survival of fibula flaps, the incidence of fibula graft or tibia fractures, recurrence of MRONJ, and patient survival status. Function assessments focused on speech, swallowing, and ankle joint.

Results: Seven patients (two with multiple myeloma, five with bone metastases) were included. Two patients experienced delayed healing at the donor site, both of whom recovered within two months postoperatively. All fibula flaps survived with primary healing. There were no recurrences of MRONJ or fractures of fibula graft or tibia. The mean speech function score was 28.00 ± 12.03, the mean swallowing function score was 2.86 ± 2.79, the mean pain score of donor site was 2.71 ± 2.29, and the mean ankle function score was 94.43 ± 4.35.

Conclusion: Fibula flap reconstruction is feasible for maxillary stage 3 MRONJ, yielding satisfactory surgical outcomes and functional recovery.

上颌3期药物相关性骨坏死的腓骨瓣重建:一项初步的单中心研究
背景:虽然下颌3期药物相关性颌骨坏死(MRONJ)的手术治疗有充分的文献记载,但对上颌3期MRONJ的研究有限。抗吸收药物可诱导MRONJ和非典型股骨骨折(AFF),但其对腓骨瓣重建可行性的影响仍存在争议。本研究旨在评估上颌3期MRONJ腓骨皮瓣重建的手术效果和功能恢复,同时考虑受体和供区结果。方法:回顾性研究上颌3期MRONJ行腓骨瓣重建的患者。分析两组患者的人口学、临床特征、术后并发症、远期预后及供、受体功能恢复情况。长期结果包括腓骨瓣的存活、腓骨移植物或胫骨骨折的发生率、MRONJ的复发和患者的生存状态。功能评估主要集中在言语、吞咽和踝关节。结果:纳入7例患者(2例多发性骨髓瘤,5例骨转移)。两名患者在供体部位出现延迟愈合,均在术后两个月内恢复。所有腓骨皮瓣均存活并初步愈合。无MRONJ复发、腓骨移植物或胫骨骨折。平均言语功能评分为28.00±12.03分,平均吞咽功能评分为2.86±2.79分,平均供区疼痛评分为2.71±2.29分,平均踝关节功能评分为94.43±4.35分。结论:腓骨皮瓣重建对上颌3期MRONJ是可行的,手术效果满意,功能恢复良好。
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来源期刊
BMC Oral Health
BMC Oral Health DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.90
自引率
6.90%
发文量
481
审稿时长
6-12 weeks
期刊介绍: BMC Oral Health is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of disorders of the mouth, teeth and gums, as well as related molecular genetics, pathophysiology, and epidemiology.
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