Bone graft necrosis of facial translocation: comparison of 3 different techniques.

Objective: To compare the viability of translocated facial bone grafts among 3 different techniques of facial translocation: free bone graft (FBG), attached bone graft (ABG), and modified facial translocation (MFT).

Study Design: A total of 107 patients were divided into 3 groups: FBG group without reconstruction (N = 33), ABG group (N = 14), and FBG group with reconstruction using a flap (FBG[R+] and MFT) (N = 60). Data evaluated included the respective incidence of bone graft necrosis (BGN) and the impact of radiotherapy.

Results: The incidence of BGN significantly varied among the three different groups (P = 0.00003): FBG[R-] (11/33[33.3%]), ABG (1/14[7.1%]) and FBG[R+] and MFT (1/60[1.67%]). Soft tissue reconstruction significantly decreased the incidence of BGN (P = 0.00003), even in patients with radiation therapy (P = 0.00001).

Conclusions: MFT significantly increases the viability of translocated facial bone grafts, which provides a good surgical approach to the anterior skull base.