A two-year audit of non-vascularized iliac crest bone graft for mandibular reconstruction: technique, experience and challenges
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Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions.Materials and Methods: A retrospective review of medical records and patient case filesfrom January 2012 to December 2013 was undertaken. All case filesand other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed recon-struction were selected for review.Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients’ (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean 26.0±10.6 years). Indi-cations for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmen-tal resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients’ postoperative reviews and radiographs revealed good facial profie and continued bone stability up to 1 year following NVIBG.Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.
Abstract
Objectives: Non-vascularized iliac crest bone graft (NVIBG) is a known treatment option in mandibular reconstruction following jaw resection, but no documented review of patients treated with NVIBG exists for northern Nigeria. The experience and technique from a Nigerian tertiary hospital may serve as baseline data for comparison and improvement of practice for other institutions.Materials and Methods: A retrospective review of medical records and patient case filesfrom January 2012 to December 2013 was undertaken. All case filesand other medical records of patients who had reconstruction with NVIBG for benign or malignant lesions with immediate or delayed recon-struction were selected for review.Results: Twenty patients had mandibular reconstruction with NVIBG during the study period. Two patients were excluded because of incomplete medical records. Eighteen patients’ (male=14, female=4) records were reviewed. Their ages ranged from 13 to 62 years (mean 26.0±10.6 years). Indi-cations for NVIBG included jaw tumors (n=16; 88.3%), jaw cyst (n=1; 5.6%) and gunshot injury (n=1; 5.6%). Jaw tumors seen were ameloblastoma (n=15; 83.3%) and osteosarcoma (n=1; 5.6%). Treatments done were mandibular resection with condylar resection (n=7; 38.9%), mandibular segmen-tal resection (n=10; 55.6%) and subtotal mandibulectomy (n=1; 5.6%). Patients’ postoperative reviews and radiographs revealed good facial profie and continued bone stability up to 1 year following NVIBG.Conclusion: NVIBGs provide an acceptable alternative to vascularized bone grafts, genetically engineered bone, and distraction osteogenesis for mandibular reconstruction in resource-limited centers.
참고문헌 (18)
- Head C, "Microvascular flap reconstruction of the mandible: a comparison of bone grafts and bridging plates for restoration of mandibular continuity", Otolaryngol Head Neck Surg, 129, pp.48~54 (2003)
- Obiechina AE, "Mandibular segmental reconstruction with iliac crest", West Afr J Med, 22, pp.46~49 (2003)
- Takahashi T, "Distraction osteogenesis for reconstruction after mandibular segmental resection", Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 93, pp.21~26 (2002)
- McCarthy JG, "Lengthening the human mandible by gradual distraction", Plast Reconstr Surg, 89, pp.1~8 (1992)
- Abukawa H, "Reconstruction of mandibular defects with autologous tissueengineered bone", J Oral Maxillofac Surg, 62, pp.601~606 (2004)
- Pogrel MA, "A comparison of vascularized and nonvascularized bone grafts for reconstruction of mandibular continuity defects", J Oral Maxillofac Surg, 55, pp.1200~1206 (1997)
- Tidstrom KD, "Reconstruction of mandibular discontinuity with autogenous iliac bone graft: report of 34 consecutive patients", J Oral Maxillofac Surg, 48, pp.336~346 (1990)
- Burkey BB, "Current concepts in oromandibular reconstruction", Otolaryngol Clin North Am, 30, pp.607~630 (1997)
- Ogunlade SO, "Autogenouscortico-cancellous iliac bone graft in reconstruction of mandibular bone defects: point of technique", Afr J Biomed Res, 13, pp.157~160 (2010)
- O'Brien CJ, "Reconstruction of the mandible with autogenous bone following treatment for squamous carcinoma", Aust N Z J Surg, 56, pp.707~715 (1986)
- Kurz LT, "Harvesting autogenous iliac bone grafts. A review of complications and techniques", Spine (Phila Pa 1976), 14, pp.1324~1331 (1989)
- Okoje VN, "Mandibular defect reconstruction with nonvascularized iliac crest bone graft", Niger J Clin Pract, 15, pp.224~227 (2012)
- Boyd JB, "Classification of mandibular defects", Plast Reconstr Surg, 92, pp.1266~1275 (1993)
- Mehta RP, "Mandibular reconstruction in 2004: an analysis of different techniques", Curr Opin Otolaryngol Head Neck Surg, 12, pp.288~293 (2004)
- Egyedi P, "Wound infection after mandibular reconstruction with autogenous graft", Ann Acad Med Singapore, 15, pp.340~345 (1986)
- Kudo K, "Evaluation of mandibular reconstruction techniques following resection of malignant tumors in the oral region", J Oral Maxillofac Surg, 50, pp.14~21 (1992)
- 이승훈, "장골이식 공여부의 합병증 및 후유증에 관한 후향적 연구", 대한구강악안면외과학회지, 36(5), pp.380~385 (2010), 대한구강악안면외과학회
- Coleman SC, "Increasing use of the scapula osteocutaneous free flap", Laryngoscope, 110, pp.1419~1424 (2000)