The chimeric ALT-vastus lateralis free flap in reconstruction of advanced BRONJ of the maxilla.

IntroductionBisphosphonate-related osteonecrosis of the jaw (BRONJ) is a dangerous complication of bisphosphonates, a class of pharmaceutical agents used in numerous bone disor- ders.No gold standard therapy exists, but recent literature suggests that, in advanced stages, the best results are achieved with aggressive debridement.In this paper, we report our experience of treatment of stage 3 BRONJ of the maxilla with extensive surgical debridement and reconstruction with a chimeric ALT-Vastus lateralis flap.MethodsFive selected patients with stage 3 BRONJ underwent partial maxillectomy with dis- ease-free margins followed by immediate reconstruction with a chimeric ALT-Vastus lateralis free flap.ResultsOnly two patients experienced minor complications. All other patients healed unevent- fully within two weeks and donor site morbidity was minimal.ConclusionsOur data suggest that aggressive debridement and reconstruction with a chimeric ALT -Vastus lateralis flap is an effective option for the treatment of stage III BRONJ of the maxilla.