Free Flap Reconstruction for Malignant Pediatric Jaw Tumors: A Palliative Approach

Authors

Raina K. Patel, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
Valeria Mejia, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
Melanie Bakovic, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
Asli Pekcan, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
Marvee Turk, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
Priyanka Naidu, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
Mark M. Urata, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.
Jeffrey A. Hammoudeh, Division of Plastic and Maxillofacial Surgery, Children's Hospital Los Angeles, Los Angeles, California, USA.

Document Type

Journal Article

Publication Date

7-7-2025

Journal

Head & neck

DOI

10.1002/hed.28241

Keywords

child; disease progression; fibula; jaw neoplasms; morbidity

Abstract

BACKGROUND: Malignant pediatric jaw tumors are rare but challenging entities. While unresectable tumors are typically managed with chemotherapy and supportive care, our institution advocates for aggressive surgery to reduce local disease progression. METHODS: We retrospectively reviewed children treated for jaw tumors at a tertiary children's hospital (2006-2024). Patients with maxillary or mandibular cancers and distant metastases who underwent palliative resection followed by microsurgical reconstruction were included. Data on demographics, oncologic history, and outcomes were collected. RESULTS: Seven patients (mean 13.1 years) underwent resection compared to two unresected patients. Reconstruction utilized free osteocutaneous fibula (4), anterolateral thigh (2), and rectus abdominis (1). Positive resection margins occurred in 57%, with no flap losses but 43% requiring revision. Four patients expired (mean 1.3 years post-surgery). Most patients showed improvement in pain, feeding, and speech. CONCLUSIONS: Aggressive surgical management of metastatic pediatric jaw cancers can improve quality of life, despite incomplete resection.

APA Citation

Patel, Raina K.; Mejia, Valeria; Bakovic, Melanie; Pekcan, Asli; Turk, Marvee; Naidu, Priyanka; Urata, Mark M.; and Hammoudeh, Jeffrey A., "Free Flap Reconstruction for Malignant Pediatric Jaw Tumors: A Palliative Approach" (2025). GW Authored Works. Paper 7635.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7635

Department

School of Medicine and Health Sciences Student Works