Composite Lower Jaw Reconstruction

MILLARD, RALPH D.; GARST, WALTER P.; Campbell, Robert C.; Schillebeeckx, P.; STOKLEY, H.

doi:10.1097/00006534-197046010-00004

Cited by 22 publications

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“…Before the advent of bony free flaps and rigid reconstruction plates, children with benign or malignant jaw tumors were preferentially reconstructed by the placement of a bone graft and immobilization with maxillomandibular fixation [ 44 , 45 ]. Although this strategy provided a favorable and functional result in a single operation, it was also associated with high infection rates and insufficient bone stock for dental rehabilitation [ 46 , 47 ]. The use of rigid reconstruction plates allows a negative margin resection while preserving the occlusion until a definitive bony reconstruction is planned in the absence of tumor recurrence [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: a case report

Maby¹,

Guay²,

Thuot³

2019

J of Otolaryngol - Head & Neck Surg

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BackgroundInfantile myofibromatosis is the most common benign fibrous tumor in infants. Three different types have been reported in the literature. The most commonly affected areas are the head, the neck and the trunk. Our patient showed a very high level of mandibular destruction resistant to all mandibular sparing treatment strategies requiring segmental mandibulectomy and complex reconstruction.Case presentationWe describe a rare case of multicentric infantile myofibromatosis with mandibular bone destruction. The treatment required a succession of chemotherapy, a subtotal transoral resection and a hemi-mandibulectomy. The mandibular reconstruction was staged with initial bridging titanium plate with a submental flap, followed later by a fibula free flap.ConclusionMandibular involvement by myofibromatosis is rare, and the extend of bone destruction and reconstruction make this case unique. To our knowledge, this is the only reported case of fibula free flap mandibular reconstruction in a patient with infantile myofibromatosis , as well as one of the youngest reported submental island flaps for any pathology. We describe the clinical presentation and management, including relevant imaging, histopathology, medical and surgical treatment as well as a review of relevant literature.

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Section: Discussionmentioning

confidence: 99%

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: a case report

Maby¹,

Guay²,

Thuot³

2019

J of Otolaryngol - Head & Neck Surg

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Reconstruction After Mandibulectomy for Cancer

Snow¹,

Kruisbrink²,

Slooten³

1976

Arch Otolaryngol

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Immediate reconstruction of the mandible using a vascularized segment of radius

1986

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Resection of a segment of mandible, particularly when associated with malignant disease, carries a high morbidity and mortality. Traditional methods of autogenous bone grafting have proved unreliable in immediate reconstruction of such mandibular defects because of the variability of the recipient bed. These unfavorable conditions for bone graft survival can be largely overcome using vascularized bone and vascularized soft tissue reconstruction. The radial forearm free flap has proved a versatile and useful method in intraoral reconstruction and can be used together with a segment of radius as a composite flap. The technique of raising a segment of vascularized radius is described and its use in immediate reconstruction of the mandible at the time of resection illustrated in a series of 14 consecutive cases. There was one microvascular failure in this series and one postoperative death. The remaining 12 cases have had a successful outcome and show clinical union in the follow‐up period varying from 11‐36 months. There is evidence indicating that the bone maintains its viability even in the presence of preoperative or early postoperative radiotherapy.

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Composite Lower Jaw Reconstruction

Cited by 22 publications

References 0 publications

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: a case report

Infantile myofibromatosis treated by mandibulectomy and staged reconstruction with submental flap and free fibula flap: a case report

Reconstruction After Mandibulectomy for Cancer

Immediate reconstruction of the mandible using a vascularized segment of radius

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