Objective To assess the effectiveness and reliability of free flap transferfortreatingthe advanced osteoradionecrosis (ORN)of mandible.Methods Eleven cases of free flap transfer for treating the advanced ORN of mandible from October 1999 to February 2003 were reviewed. Data concerning the operation included site, stage and histology of primary tumor, dosage of radio- therapy, defect description, design of free flap, recipient vessel, free flap survival and complications.Results There were 8 males and 3 females, with age ranged 29-65 years old. Fifteen free flaps were used for reconstructing the defects, 12 were fibula flap, 2 were rectus abdominismyocutaneous flap, and 1 was radial forearmflap. All the free flaps survived completelywithout par- tial or total necrosis. The complication rate was 36.4%. All patients had complete resolution of ORN symptoms. No evidence of ORNrecurrencewas observed in any patient.Conclusion Free flap transfer provides a reliable and effective means fortreatingthe advanced ORN of mandible. Free fibula flap is the workhorse flap for reconstruction of mandible.
