Distraction osteogenesis in the irradiated mandible. A case report

Background: Distraction osteogenesis has been suggested as a relatively simple method of mandibular reconstruction following ablative head and neck surgery. Some authors report good results in irradiated patients while other authors report limitations with this group of patients. Patient: In a 72-year-old male an attempt was made to reconstruct the irradiated mandible using distraction osteogenesis. Results: Distraction osteogenesis only resulted in an enlarged soft tissue envelope, while there was no evidence of bone formation in the distraction gap. Conclusion: Based on this experience and a search of the literature, it is hypothesized that distraction osteogenesis is only a reliable reconstructive method in irradiated patients if the cumulative dose to the mandibular bone at the distraction site does not exceed a certain maximum still to be defined. (c) 2005 European Association for Cranio-Maxillofacial Surgery.