POSSIBILITIES OF THE USE OF REVASCULARIZED AND NONVASCULARIZED AUTOGRAFTS IN RECOVERY OF POSTOPERATIVE LOWER JAW DEFECTS

The article is devoted to evaluating the possibilities of using revascularized and nonvascularized autografts in the reconstruction of postoperative defects of the lower jaw after resection for tumours and tumour-like lesions. The study included 43 patients with mandibular defects formed after resection, hemiresection, and subtotal resection with disarticulation. Depending on the clinical situation, reconstruction was performed using nonvascularized iliac crest grafts as well as vascularized grafts from the radius and fibula combined with reconstructive titanium plates and miniplates. It was shown that the choice of graft depended on the type and extent of the defect and on whether the continuity of the mandible was preserved. The authors consider the vascularized fibular autograft to be the most effective material for reconstruction of extensive defects without preservation of mandibular continuity. It was noted that the use of reconstructive titanium implants made it possible to preserve the anatomical position of mandibular fragments and avoid additional maxillomandibular immobilization. The obtained results indicate the high effectiveness of the proposed approach, since positive outcomes were achieved in 95% of the operated patients.