Author(s)
Nina Patel, MS, MPhil
Autefeh Sajjadi, MD
Andrea Park, MD
Rahul Seth, MD
Chase Heaton, MD
Mary Jue Xu, MD
Katherine Wai, MD
P. Daniel Knott, MD
Affiliation(s)
University of California San Francisco
Abstract:
Educational Objective: At the conclusion of this presentation, the participants should be able to compare clinical outcomes and complication rates among surgeon specific, patient specific, and conventional mandibular reconstruction plates and evaluate how plating technique, flap type, and defect location may affect surgical decision making and postoperative outcomes.
Objectives: Mandibular free flap reconstruction requires stable fixation, commonly with surgeon specific plates (SSP), patient specific plates (PSP), or conventional unbent plates (UP). The relative impact of plate type on complications remains unclear. This study seeks to compare clinical outcomes and complication rates associated with SSP, PSP, and UP used in osseous mandible reconstruction.
Study Design: Single institution retrospective cohort of 181 reconstructions (2020-2025): SSP (n=61), PSP (n=58), UP (n=61).
Methods: Data was collected on demographics, indication, defect site/size, flap type, plate size, prior/adjuvant radiation or chemotherapy, operative metrics, and complications (flap failure, infection/dehiscence, hematoma, fistula, plate extrusion, screw loosening, hardware failure, OR take back, revision).
Results: Mean age 64.4 +/=14.4 years; 52% male. Indication was most commonly tumor (74%). Fibula flaps predominated (76%). Hemi mandible plates were used in 69% overall; full plates were more frequent in SSP (p<0.05). Reconstruction plates had 2.0 mm profile heights across the SSP, PSP, and UP groups. Mean operative time was longest with PSP (705 +/=113 minutes) vs SSP (662 +/=139) and UP (673+/=108), however not significant (p=0.16). Length of stay was similar (9.6-9.8 days). Complications were comparable across groups: flap failure (6-7%), infection/dehiscence (3-13%), hematoma (3-7%), fistula (Conclusions: SSP, PSP, and UP demonstrated similar complication rates and clinical outcomes despite procedural differences. Plate selection may reasonably be guided by surgeon preference, patient factors (including radiation history), and institutional resources rather than expectations of improved outcomes by plate type alone.