Comparison of reconstructive procedures in primary versus secondary mandibular reconstruction.

Abstract

Few reports have compared reconstructive outcomes of primary versus secondary mandibular reconstruction. A retrospective chart review was performed on 149 patients following primary (n = 110) and secondary reconstruction (n = 39). There was no statistically significant difference in patient demographics between the 2 groups. The secondary reconstruction mandibular defects were more extensive; significantly more involved the condyle or the central portion of the mandible. The vascularized fibular flap was most commonly used (primary 82%, secondary 69%). The overall complication rate was similar in both groups. There was no statistical difference in the frequency of complications between the primary or secondary reconstruction groups (acute, p = .40; late, p = .17). Success in secondary mandibular reconstruction could be achieved utilizing a range of osseous free flaps, and there was no increased rate of complications compared with primary mandibular reconstructions.