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Faverani LP, Rios BR, Santos AMDS, Mendes BC, Santiago-Júnior JF, Sukotjo C, Callahan N, Miloro M. Predictability of single versus double-barrel vascularized fibula flaps and dental implants in mandibular reconstructions: A systematic review and meta-analysis of prospective studies. J Prosthet Dent 2023:S0022-3913(23)00686-8. [PMID: 37978003 DOI: 10.1016/j.prosdent.2023.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 11/19/2023]
Abstract
STATEMENT OF PROBLEM Patients with vascularized bone flaps from the fibula have reduced bone height, in which case a higher prosthetic abutment is needed for their implant-supported prosthesis. Although the double-flap technique seems promising, systematic reviews and meta-analyses of prospective studies are lacking. PURPOSE The purpose of this systematic review and meta-analysis was to evaluate the grafted areas of single barrel fibular flaps (SBFF) and double-barrel fibular flaps (DBFF) by considering failure rates, dental implant complications, and bone union at the osteotomy sites. MATERIAL AND METHODS A systematic review and meta-analysis was performed in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) statement, population, intervention, control, and outcomes (PICO) question, and the National Health and Medical Research Council scales. The event rate of complications and failures was calculated with a confidence interval (CI) of 95%. RESULTS A total of 13 prospective studies with 441 participants and 330 graft sites were identified. A total of 235 participants had SBFF with 445 implants, and 95 had DBFF with 164 implants. The overall combined graft failure rates were 4.2% for SBFF and 3.2% for DBFF. The complication rate was 10% for SBFF and 1.9% for DBFF. Implant failure was at 4.7% in the SBFF group and 3.4% in the DBFF group. CONCLUSIONS Complication rates and implant failures were similar for SBFF and DBFF. Therefore, for long-term oral rehabilitation, both SBFF and DBFF are suitable procedures for mandibular reconstruction.
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Affiliation(s)
- Leonardo P Faverani
- Associate Professor, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery and Implantology, São Paulo State University (UNESP), Araçatuba, SP, Brazil.
| | - Barbara R Rios
- PhD student, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Anderson Maikon de Souza Santos
- PhD student, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Bruno C Mendes
- PhD student, Department of Diagnosis and Surgery, Division of Oral and Maxillofacial Surgery, School of Dentistry, São Paulo State University (UNESP), Araçatuba, SP, Brazil
| | - Joel F Santiago-Júnior
- Assistant Professor, Department of Health Sciences, Sacred Heart University, Bauru, SP, Brazil
| | - Cortino Sukotjo
- Associate Professor, Department of Restorative Dentistry, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
| | - Nicholas Callahan
- Assistant Professor, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
| | - Michael Miloro
- Professor and Head of Department, Department of Oral and Maxillofacial Surgery, College of Dentistry, University of Illinois at Chicago, Chicago, Ill
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Idris S, Logan H, Tabet P, Osswald M, Nayar S, Seikaly H. The Accuracy of 3D Surgical Design and Simulation in Prefabricated Fibula Free Flaps for Jaw Reconstruction. J Pers Med 2022; 12:jpm12111766. [PMID: 36579487 PMCID: PMC9698275 DOI: 10.3390/jpm12111766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 09/26/2022] [Accepted: 09/30/2022] [Indexed: 01/01/2023] Open
Abstract
The ideal jaw reconstruction involves the restoration and maintenance of jaw continuity, jaw relations, joint alignment, and facial contour, and, most importantly, dental occlusal reconstruction. One of the essential requirements of achieving a consistent functional outcome is to place the bony reconstruction in the correct three-dimensional position as it relates to the other jaw segments and dentition. A protocol of occlusion-driven reconstruction of prefabricated fibular free flaps that are customized to the patient with surgical design and simulation (SDS)-planned osseointegrated implant installation was developed by our institution. This innovation introduced significant flexibility and efficiency to jaw reconstructions, but functional and cosmetic outcomes were dependent on the accuracy of the final reconstructions when compared to the SDS plan. The purpose of this study was to examine the accuracy of the SDS-planned fibular flap prefabrication in a cohort of patients undergoing jaw reconstruction. All patients that had undergone primary jaw reconstruction with prefabricated fibular free flaps were reviewed. The primary outcome of this study was the accuracy of the postoperative implant positions as compared to the SDS plan. A total of 23 implants were included in the analysis. All flaps survived, there was no implant loss postoperatively, and all the patients underwent all stages of the reconstruction. SDS planning of fibular flap prefabrication resulted in better than 2 mm accuracy of osteointegrated implant placement in a cohort of patients undergoing jaw reconstruction. This accuracy could potentially result in improved functional and cosmetic outcomes.
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Affiliation(s)
- Sherif Idris
- Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada
| | - Heather Logan
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, AB T5R 4H5, Canada
| | - Paul Tabet
- Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Division of Otolaryngology-Head & Neck Surgery, Department of Surgery, Université de Montréal, Montreal, PQ H1T 2M4, Canada
| | - Martin Osswald
- Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, AB T5R 4H5, Canada
| | - Suresh Nayar
- Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, AB T5R 4H5, Canada
| | - Hadi Seikaly
- Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB T6G 2B7, Canada
- Institute for Reconstructive Sciences in Medicine, Misericordia Community Hospital, Edmonton, AB T5R 4H5, Canada
- Correspondence: ; Tel.: +1-(780)-407-3691
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Bone Augmentation for Implant Placement: Recent Advances. Int J Dent 2022; 2022:8900940. [PMID: 35386549 PMCID: PMC8977324 DOI: 10.1155/2022/8900940] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/27/2021] [Accepted: 03/11/2022] [Indexed: 01/19/2023] Open
Abstract
There are various advancements in biomaterials and methods for bone augmentation. This article aims to review the recent advances in bone augmentation for dental implants. Relevant articles on bone augmentation for dental implants were searched in PubMed/Medline, Scopus, Google Scholar, and Science Direct published in English literature published between January 1996 and March 2021. Relevant studies on bone grafts for dental implants were included and critically analyzed in this review. Various biomaterials can be used to augment bone for implant placement. Each graft procedure has advantages and disadvantages in each clinical application and needs to choose the graft material with a high success rate and less morbidity.
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Khadembaschi D, Brierly GI, Chatfield MD, Beech N, Batstone MD. Systematic review and pooled analysis of survival rates, success, and outcomes of osseointegrated implants in a variety of composite free flaps. Head Neck 2020; 42:2669-2686. [PMID: 32400954 DOI: 10.1002/hed.26238] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Revised: 04/02/2020] [Accepted: 04/22/2020] [Indexed: 09/19/2023] Open
Abstract
The aim of this review was to provide an update on survival rates of osseointegrated implants into common composite free flaps used for maxillary and mandibular reconstructions and identify factors affecting outcomes. PubMed, Medline, Embase, and Cochrane databases were searched. Included studies reported implant survival by flap type. Results were pooled and survival was estimated with the Kaplan-Meier method. Variables affecting survival were assessed using Cox regression. Thirty-two of the 2631 articles retrieved were included, totaling 2626 implants placed into fibula, iliac crest, scapula, and radial forearm free flaps. Pooled survival showed 94% 5-year survival of implants in fibula and iliac crest with no difference between groups (P = .3). Factors effecting survival included radiotherapy (HR 2.3, 95% CI 1.2-4.6, P = .027) and malignant disease (HR 2.2, 95%CI 1.6-3.1, P < .001). Implant survival appears adequate across common flap types; however, there are limited numbers reported in less common flaps.
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Affiliation(s)
- Darius Khadembaschi
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Gary I Brierly
- Department of Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Mark D Chatfield
- Faculty of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Nicholas Beech
- Department of Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Martin D Batstone
- Department of Maxillofacial Surgery, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
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Lee DH, Kim SR, Jang S, Ahn KM, Lee JH. Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction. Maxillofac Plast Reconstr Surg 2020; 42:21. [PMID: 32607318 PMCID: PMC7311605 DOI: 10.1186/s40902-020-00266-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 06/17/2020] [Indexed: 11/16/2022] Open
Abstract
Background Fibula free flap mandible reconstruction is the standard procedure after wide resection of the mandible. Establishment and maintenance of normal occlusion are important in mandible reconstruction both intraoperatively and after surgery. However, scar formation on the surgical site can cause severe fibrosis and atrophy of soft tissue in the head and neck region. Case presentation Here, we report a case of severe soft tissue atrophy that appeared along with scar formation after mandibular reconstruction through the fibular free flap procedure. This led to normal occlusion collapse after it was established, and the midline of the mandible became severely deviated to the affected side that was replaced with the fibula free flap, leading to facial asymmetry. We corrected the malocclusion with a secondary operation: a sagittal split ramus osteotomy on the unaffected side and a sliding osteotomy on the previous fibula graft. After a healing time of 3 months, implants were placed on the fibula graft for additional occlusal stability. Conclusion We report satisfactory results from the correction of malocclusion after fibula reconstruction using sliding fibula osteotomy and sagittal split ramus osteotomy. The midline of the mandible returned to its original position and the degree of facial asymmetry was reduced. The implants reduced difficulties that the patient experienced with masticatory function.
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Affiliation(s)
- Dong-Hun Lee
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Seong Ryoung Kim
- Department of Oral and Maxillofacial Surgery, Asan Medical Center, Seoul, Republic of Korea
| | - Sam Jang
- Coreline Soft, Seoul, Republic of Korea
| | - Kang-Min Ahn
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-ro, Songpa-gu, Seoul, 05505 Republic of Korea
| | - Jee-Ho Lee
- Department of Oral and Maxillofacial Surgery, College of Medicine, Asan Medical Center, University of Ulsan, 88, Olympic-ro, Songpa-gu, Seoul, 05505 Republic of Korea
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Abstract
Palatomaxillary reconstruction presents a unique challenge for the reconstructive surgeon. The maxillofacial skeleton preserves critical aerodigestive functions-it provides a stable hard palate to support mastication and separate the nasal and oral cavities, and buttress support to provide adequate midface contour. Free tissue transfer has become a routine part of the reconstructive ladder in managing palatomaxillary defects. While there is a wide variety of options for bony reconstruction within the head and neck, the fibula and the scapula, and their variations, have become two of the most commonly used options for midface reconstruction. This review will discuss the advantages and disadvantages of both in specific regard to reconstruction of the palatomaxillary area.
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Affiliation(s)
- Arvind K. Badhey
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mohemmed N. Khan
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York
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7
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Dziegielewski PT, Bernard S, Mendenhall WM, Hitchock KE, Parker Gibbs C, Wang J, Amdur RJ, Silver NL, Hardeman J, Seikaly H, Reschly WJ, Danan D, Sawhney R. Osteoradionecrosis in osseous free flap reconstruction: Risk factors and treatment. Head Neck 2020; 42:1928-1938. [DOI: 10.1002/hed.26118] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 01/15/2020] [Accepted: 02/11/2020] [Indexed: 11/09/2022] Open
Affiliation(s)
- Peter T. Dziegielewski
- Department of OtolaryngologyUniversity of Florida Gainesville Florida
- University of Florida Health Cancer Center Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Stewart Bernard
- Department of OtolaryngologyUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - William M. Mendenhall
- University of Florida Health Cancer Center Gainesville Florida
- Department of Radiation OncologyUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Kathryn E. Hitchock
- University of Florida Health Cancer Center Gainesville Florida
- Department of Radiation OncologyUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Charles Parker Gibbs
- Department of Orthopedic SurgeryUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Joy Wang
- Department of Restorative DentistryUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Robert J. Amdur
- University of Florida Health Cancer Center Gainesville Florida
- Department of Radiation OncologyUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Natalie L. Silver
- Department of OtolaryngologyUniversity of Florida Gainesville Florida
- University of Florida Health Cancer Center Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - John Hardeman
- Department of Oral and Maxillofacial SurgeryUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Hadi Seikaly
- Department of Oral and Maxillofacial SurgeryUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - William J. Reschly
- Department of OtolaryngologyUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Deepa Danan
- Department of OtolaryngologyUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Raja Sawhney
- Department of OtolaryngologyUniversity of Florida Gainesville Florida
- Division of Otolaryngology‐Head and Neck SurgeryUniversity of Alberta Edmonton Alberta Canada
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8
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Yao CMKL, Chang EI, Lai SY. Contemporary Approach to Locally Advanced Oral Cavity Squamous Cell Carcinoma. Curr Oncol Rep 2019; 21:99. [PMID: 31701240 DOI: 10.1007/s11912-019-0845-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
PURPOSE OF REVIEW Surgical management of locally advanced oral cavity squamous cell carcinomas (OCSCC) has long been recognized as a primary treatment modality. Technological advances have led to significant improvements in our surgical approach, from improvement in the visualization of tumors to more efficient and precise reconstruction. Here, we review the latest technological advances in surgical extirpation and reconstruction of locally advanced OCSCCs. RECENT FINDINGS The focus of technological innovation in surgical extirpation has been on improving visualization, with the use of intraoperative ultrasound for margin delineation, intraoperative navigation, narrow-band imaging, and the use of fluorescence. Though early, these are promising steps to ensuring complete resection of the cancer. Advances in reconstruction have been centered on the incorporation of computer assisted design, manufacturing, and virtual surgical planning, allowing for more complex three-dimensional defects to be expeditiously reconstructed. As these technologies are still under development, their impact on oncologic outcomes are not yet robustly defined; however, as technology continues to advance and become more widely available, new technologies will undoubtedly become integrated into enhancing surgical precision and planning.
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Affiliation(s)
- Christopher M K L Yao
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1445, Houston, TX, 77030, USA.
| | - Edward I Chang
- Department of Plastic Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1258, Houston, TX, 77030, USA.
| | - Stephen Y Lai
- Department of Head and Neck Surgery, Division of Surgery, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd. Unit 1445, Houston, TX, 77030, USA.
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Seikaly H, Idris S, Chuka R, Jeffery C, Dzioba A, Makki F, Logan H, O'Connell DA, Harris J, Ansari K, Biron V, Cote D, Osswald M, Nayar S, Wolfaardt J. The Alberta Reconstructive Technique: An Occlusion‐Driven and Digitally Based Jaw Reconstruction. Laryngoscope 2019; 129 Suppl 4:S1-S14. [DOI: 10.1002/lary.28064] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 04/23/2019] [Indexed: 12/18/2022]
Affiliation(s)
- Hadi Seikaly
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
- Institute for Reconstructive Sciences in MedicineMisericordia Hospital Edmonton Alberta Canada
| | - Sherif Idris
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Richelle Chuka
- Institute for Reconstructive Sciences in MedicineMisericordia Hospital Edmonton Alberta Canada
| | - Caroline Jeffery
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
- Institute for Reconstructive Sciences in MedicineMisericordia Hospital Edmonton Alberta Canada
| | - Agnieszka Dzioba
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Fawaz Makki
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Heather Logan
- Institute for Reconstructive Sciences in MedicineMisericordia Hospital Edmonton Alberta Canada
| | - Daniel A. O'Connell
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
- Institute for Reconstructive Sciences in MedicineMisericordia Hospital Edmonton Alberta Canada
| | - Jeffrey Harris
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Kal Ansari
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Vincent Biron
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - David Cote
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
| | - Martin Osswald
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
- Institute for Reconstructive Sciences in MedicineMisericordia Hospital Edmonton Alberta Canada
| | - Suresh Nayar
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
- Institute for Reconstructive Sciences in MedicineMisericordia Hospital Edmonton Alberta Canada
| | - John Wolfaardt
- Division of Otolaryngology–Head and Neck Surgery, Department of SurgeryUniversity of Alberta Edmonton Alberta Canada
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Eskander A, Kang SY, Teknos TN, Old MO. Advances in midface reconstruction: beyond the reconstructive ladder. Curr Opin Otolaryngol Head Neck Surg 2017; 25:422-430. [DOI: 10.1097/moo.0000000000000396] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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11
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Varadarajan VV, Pace EK, Patel V, Sawhney R, Amdur RJ, Dziegielewski PT. Follicular thyroid carcinoma metastasis to the facial skeleton: a systematic review. BMC Cancer 2017; 17:225. [PMID: 28351395 PMCID: PMC5370488 DOI: 10.1186/s12885-017-3199-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 03/15/2017] [Indexed: 12/19/2022] Open
Abstract
Background Follicular thyroid carcinoma (FTC) metastasis to the facial skeleton is exceedingly rare. A case of FTC metastasizing to the mandible is presented and a systematic review of the literature describing thyroid metastasis to the facial skeleton is performed. Case presentation A 73-year-old female presented with metastatic FTC to the mandible and underwent total thyroidectomy, segmental mandibulectomy, bone impacted fibular free flap reconstruction, and adjuvant radioactive iodine treatment. The PubMed database was searched for literature describing thyroid cancer with facial skeleton metastasis using the key words “thyroid,” “cancer,” “carcinoma,” “metastasis,” and “malignancy” with “oral cavity,” “maxilla,” “mandible,” “sinus,” “paranasal,” and “orbit.” Reports that only involved the soft tissues were excluded. Systematic review revealed 59 cases of well-differentiated thyroid cancer with facial skeleton metastasis: 35 mandibular metastases (21 = FTC), 6 maxilla metastases (2 = FTC), 9 orbital metastases (4 = FTC), and 11 paranasal sinus metastases (7 = FTC). Treatment included surgery, RAI, external beam radiotherapy (XRT), or a combination of these modalities. The one, two, and five-year survival rates were 100%, 79%, and 16%, respectively. Conclusion Facial skeleton metastasis of FTC is a rare clinical challenge. Optimal treatment appears to include total thyroidectomy and resection of involved structures with or without adjuvant treatment.
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Affiliation(s)
- Varun V Varadarajan
- Department of Otolaryngology (ENT), University of Florida, Gainesville, FL, 32610, USA
| | | | - Vatsal Patel
- Department of Pathology, University of Florida, Gainesville, FL, USA
| | - Raja Sawhney
- Department of Otolaryngology (ENT), University of Florida, Gainesville, FL, 32610, USA
| | - Robert J Amdur
- University of Florida Health Cancer Center, Gainesville, FL, USA.,Department of Radiology, University of Florida, Gainesville, FL, USA
| | - Peter T Dziegielewski
- Department of Otolaryngology (ENT), University of Florida, Gainesville, FL, 32610, USA. .,University of Florida Health Cancer Center, Gainesville, FL, USA.
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12
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Barber BR, Dziegelewski PT, Chuka R, O'Connell D, Harris JR, Seikaly H. Bone-impacted fibular free flap: Long-term dental implant success and complications compared to traditional fibular free tissue transfer. Head Neck 2015; 38 Suppl 1:E1783-7. [DOI: 10.1002/hed.24315] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Revised: 08/22/2015] [Accepted: 09/20/2015] [Indexed: 11/08/2022] Open
Affiliation(s)
- Brittany R. Barber
- Division of Otolaryngology - Head and Neck Surgery; University of Alberta; Edmonton Canada
| | - Peter T. Dziegelewski
- Division of Head and Neck Oncologic Surgery; University of Florida; Gainesville Florida
| | - Richelle Chuka
- Institute for Reconstructive Sciences in Medicine (iRSM); Edmonton Canada
| | - Daniel O'Connell
- Division of Otolaryngology - Head and Neck Surgery; University of Alberta; Edmonton Canada
| | - Jeffrey R. Harris
- Division of Otolaryngology - Head and Neck Surgery; University of Alberta; Edmonton Canada
| | - Hadi Seikaly
- Division of Otolaryngology - Head and Neck Surgery; University of Alberta; Edmonton Canada
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