Refinements in the reconstruction of bisphosphonate-related osteonecrosis of the jaw

Autor: Taku Maeda, Yuhei Yamamoto, Akira Satoh, Toshihiko Hayashi
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: JPRAS Open, Vol 35, Iss , Pp 1-5 (2023)
Druh dokumentu: article
ISSN: 2352-5878
DOI: 10.1016/j.jpra.2022.11.004
Popis: The recommended treatment strategy for stage 3 bisphosphonate-related osteonecrosis of the jaw (BRONJ) is currently rigid plate fixation without bone reconstruction. However, a recent systematic review indicated the utility of microsurgical reconstruction after resection of BRONJ. Several types of flaps have been described but their applications are controversial. Here we present a detailed reconstruction plan for obtaining better outcomes in patients with maxillary and mandibular BRONJ. Given that progressive maxillary BRONJ is often invasive to the skin, including the eyelid, leading to functional loss such as leakage of discharge and ectropion, several revision surgeries are needed to increase the volume in the defect after the free flap transfer. For progressive mandibular BRONJ, hemi-mandibulectomy to subtotal mandibulectomy with an adequate margin from the necrotic bone is necessary, followed by a well-designed fibular free flap.
Databáze: Directory of Open Access Journals