Pseudoaneurysm of the internal maxillary artery is a rare occurrence. A well-organized pulsatile mass that develops after a traumatic event indicates a pseudoaneurysm. Such lesions are commonly misdiagnosed for an abscess or a hematoma. Pulsations and audible bruit are diagnostic features of an aneurysm. Rupture of such false aneurysms cause significant morbidity. Management is either surgical resection or embolization. Endovascular embolization is indicated in deep seated lesions or lesions with high morbidity. Though surgical resection is an invasive procedure, it is considered to be an alternative to embolization.
Mandibular reconstructive surgery has changed in the recent times with the introduction of advanced techniques. Mandibular reconstruction a challenge for the reconstructive surgeons, is now reliable and highly successful with excellent long-term functional and aesthetic outcomes using vascularised fibular flap in various mandibular pathologies. The ideal reconstruction should restore the anatomic contour, speech, mastication and aesthetics. The free vascularised fibular flap is the primary source of bone for reconstruction of large segmental mandibular defects due to its rich vascularity. We present three cases of segmental mandibular defects reconstructed primarily with vascularised free fibular flap without skin paddle which were followed up for two years.
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