Factors affecting anastomosis failure in microvascular fibula flap reconstruction of the maxillofacial region:a systematic review and meta-analysis
10.5125/jkaoms.2025.51.1.3
- Author:
Elahe TAHMASEBI
1
;
Samira HAJISADEGHI
;
Shervin SHAFIEI
;
Hamidreza MOSLEMI
;
Reza TABRIZI
;
Mohammad Hosein Kalantar MOTAMEDI
Author Information
1. Research Center for Prevention of Oral and Dental Diseases, Baqiyatallah University of Medical Sciences, Tehran, Iran
- Publication Type:REVIEW ARTICLE
- From:Journal of the Korean Association of Oral and Maxillofacial Surgeons
2025;51(1):3-16
- CountryRepublic of Korea
- Language:English
-
Abstract:
This systematic review and meta-analysis evaluates the contributory factors and failure rates in anastomosis during microvascular fibula flap reconstruction in maxillomandibular regions. A comprehensive search strategy was employed across databases including MEDLINE, Web of Science,EMBASE, Scopus, Cochraneʼs CENTRAL, as well as grey literature sources, and manual searches of noteworthy journals, covering studies frominception up to April 2023. The inclusion criteria targeted retrospective or prospective cohort and clinical studies that investigated functional and dental rehabilitation outcomes in human subjects undergoing maxillofacial reconstruction using microvascular fibula flaps. Exclusion criteria encompassedcase-control studies, alternative reconstruction method research, and animal-based investigations. The studyʼs findings revealed a cumulative vascularfailure rate of 6%. Subsequent analysis delineated the primary causes of this failure, attributing 3% to venous thrombosis, 1% to arterial thrombosis, and less than 1% to blood vessel compression due to hematoma. However, notable heterogeneity across the studies indicates substantial variability in vascular failure rates reported. These results of our review and meta-analysis underscore the intricate factors impacting anastomosis success, such as anastomosis technique, recipient vessel quality, the choice between couplers.
