Objective: To analyze the association between plate contouring parameters and complications in oromandibular reconstruction.
Methods: Postoperative CT images were obtained from patients undergoing segmental mandibulectomy and free flap reconstruction between 2003-2014. Computer-based three-dimensional models were generated to calculate plate surface contact area, percentage of plate contact and mean plate to bone gap. Demographic data, complication type (surgical site infection, hardware exposure, intraoral dehiscence, neck dehiscence and orocutaneous fistula) and adjuvant treatment details were collected. Univariate/multivariate analyses were performed.
Results: Ninety-four patients were included (M=58;F=36). Reconstruction was performed with fibular (n=54) and scapular free flaps (n=40). On multivariate analyses, larger mean plate to bone gap was associated with both plate exposure (Exposed:1.67±0.5mm vs unexposed:1.11±0.4mm;p=0.02), and formation of orocutaneous fistula (Fistula:1.49±0.7mm vs No fistula:1.14±0.4mm;p=0.02). The plate surface contact area and percentage of plate contact were not associated with postoperative complications.
Conclusion: Optimizing reconstruction plate contouring may limit the development of postoperative complications.
- Review the role of three-dimensional modeling in the quantitative analysis of oromandibular reconstruction.
- Discuss the association between plate contouring parameters and postoperative complications.
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Authors' Contact Details
Corresponding Author: Dr. Joel Davies
Senior Author: Dr. Jonathan Irish
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