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Article
August 1991

Mandible Reconstruction With Vascularized Bone GraftsA Histologic Evaluation

Author Affiliations

From the Department of Surgery, Division of Otolaryngology, University of California, San Diego, Medical Center and the Veterans Affairs Medical Center, San Diego (Drs Hoffman and Robbins); the Department of Pathology, University of California, San Diego, Medical Center (Dr Harrison); the Department of Otolaryngology, University of Michigan, Ann Arbor (Drs Sullivan and Baker); and the Department of Surgery, Division of Otolaryngology, University of South Florida, Tampa (Dr Ridley). Dr Hoffman is now with the Department of Otolaryngology—Head and Neck Surgery, The University of Iowa Hospitals and Clinics, Iowa City.

Arch Otolaryngol Head Neck Surg. 1991;117(8):917-925. doi:10.1001/archotol.1991.01870200111020
Abstract

• To our knowledge, a histologic evaluation of bone healing after mandible reconstruction with vascularized human bone grafts has not been previously reported. Serial sections through both the decalcified graft and the junction between mandible and graft were evaluated in four patients who required surgical removal of their reconstructed mandibles. A failed scapular bone graft that had been wrapped within a pectoralis major myocutaneous flap for salvage following pedicle thrombosis showed markedly resorbed but viable bone with a fibrous union to the native mandible. Viable vascularized grafts without evidence of ongoing resorption characterized an iliac osteocutaneous bone graft and two scapula osteocutaneous grafts that healed with continuity of healthy bone between graft and mandible. Observations from the evaluation of these specimens are made regarding bone circulation, bone union, and bone graft survival as they occur clinically. Implications regarding the techniques of bone plating and indications for use of vascularized bone in mandible reconstruction are discussed.

(Arch Otolaryngol Head Neck Surg. 1991;117:917-925)

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