Abstract
Background: Heterotopic ossification along free flap pedicles has been reported. Reports suggest that subperiosteal dissection of the pedicle from the bone during the harvest of the fibula free flap may predispose the pedicle to heterotopic ossification. Methods: A 56-year-old man with history of a T2N1M0 squamous cell cancer of the left tonsil who was treated with chemoradiation developed osteoradionecrosis of the mandible requiring fibula free flap reconstruction. The patient presented with a firm submandibular mass 1 year after reconstruction. Results: Imaging revealed bone along the mandible projecting to the floor of the mouth. Surgery revealed heterotopic bone along the submandibular triangle and vascular pedicle. The bone was removed and the periosteum fulgurated to prevent further proliferation. Conclusion: Our practice includes a high-volume head and neck extirpative and reconstruction practice. To the best of our knowledge, this represents the first documented case of heterotopic ossification along a free flap pedicle despite routine subperiosteal elevation to free the peroneal artery from the proximal fibula.
| Original language | English (US) |
|---|---|
| Pages (from-to) | E21-E24 |
| Journal | Head and Neck |
| Volume | 40 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 2018 |
Keywords
- fibula free flap
- head and neck oncology
- head and neck reconstruction
- heterotopic ossification
- microsurgery
ASJC Scopus subject areas
- Otorhinolaryngology