Pedicle ossification following mandibular reconstruction using fibular free flap in a patient with osteoradionecrosis of the jaw: a case report

• 발행기관: 대한구강악안면외과학회
• 저자명: Jae Hee Ko Min-Gyeong Kim Sung Min Kim Ui Hyun Kong Sang Hyun Park Da Woon Kwack Joo-Yong Park Jong-Ho Lee Sung Weon Choi
• 간행물 정보: 『대한구강악안면외과학회지』제50권 제6호, 356~360쪽, 전체 5쪽
• 주제분류: 의약학 > 일반외과학
• 파일형태: PDF
• 발행일자: 2024.12.31

국문 초록

Pedicle ossification is a rare but significant complication following mandibular reconstruction using a fibular free flap (FFF), a technique widely employed in maxillofacial surgery due to its reliable vascularized bone supply and low donor site morbidity. The FFF supports dental implantation and prosthetic rehabilitation, with its vascularized periosteum enhancing osteogenic potential. Despite these advantages, unexpected ossification of the flap’s vascular pedicle may occur, potentially mimicking tumor recurrence and causing diagnostic uncertainty. This case report describes a 38-year-old male with left buccal squamous cell carcinoma treated by wide excision, modified radical neck dissection, and reconstruction using a radial forearm free flap. Postoperative radiotherapy led to complications including trismus and alveolar bone exposure, culminating in a pathological mandibular fracture. Mandibular reconstruction was performed using an FFF. Over 4 years of follow-up, computed tomography revealed ossification within the vascular pedicle. Notably, the patient remained asymptomatic, maintaining normal speech and swallowing without functional impairment. Pedicle ossification may present radiographically as a suspicious bony change misinterpreted as tumor recurrence. Routine follow-up imaging such as computed tomography is essential for differentiation. Although trismus, bony swelling, or pain may occur, surgical intervention is typically deferred unless symptoms develop. Therefore, careful clinical assessment and monitoring remain crucial.

목차

I. Introduction

II. Case Report

III. Discussion

References

키워드

Fibula Free flap Pedicle ossification Osteoradionecrosis Mandibular reconstruction