How we fix free flaps to the bone in oral and oropharyngeal reconstructions

Am J Otolaryngol. 2015 Mar-Apr;36(2):166-72. doi: 10.1016/j.amjoto.2014.10.022. Epub 2014 Oct 18.

Abstract

Purpose: The use of suture anchors has been described in orthopedic, hand, oculoplastic, temporomandibular joint and in aesthetic surgery, but no study reports the use of the Mitek® anchors (Depuy Mitek Surgical Products, Inc. Raynham, Massachusetts) for fixing the free flaps used in oncologic oral and oropharyngeal reconstruction.

Materials and methods: In this prospective non-randomized study, 9 patients underwent surgical resection of oral or oropharyngeal cancer followed by a free flap reconstruction; mini anchors were used to fix the flap directly to the bone. We collected data regarding the patients, the tumor stage, the surgical procedure, the radiotherapy and the number of anchors used.

Results: The average follow-up was 28months (range 24-38).We observed no complications with trans-oral, sub-mandibular and trans-mandibular approach in both oral and oropharyngeal reconstructions. All anchors became osteo-integrated and no complications occurred after radiotherapy.

Conclusions: In our opinion this device favors free flap adhesion to the bone. We registered no postoperative complications related to the use of the device which looks suitable for use in irradiated tissues. The radiotherapy did not cause any long-term complications related to the use of Mitek® mini bone anchors.

Publication types

  • Clinical Study

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Free Tissue Flaps / blood supply
  • Free Tissue Flaps / transplantation*
  • Graft Rejection
  • Graft Survival
  • Humans
  • Male
  • Mandible / surgery
  • Middle Aged
  • Mouth Neoplasms / pathology
  • Mouth Neoplasms / surgery*
  • Neoplasm Invasiveness / pathology
  • Neoplasm Staging
  • Oropharyngeal Neoplasms / pathology
  • Oropharyngeal Neoplasms / surgery*
  • Plastic Surgery Procedures / adverse effects
  • Plastic Surgery Procedures / methods*
  • Prospective Studies
  • Risk Assessment
  • Suture Anchors*
  • Time Factors
  • Treatment Outcome