Vascularized free fibular flap for mandibular reconstruction: A report of 26 cases

Muñoz-Guerra, M.F.; Gı́as, Luis Naval; Campo, Francisco José Rodríguez; González, Fernández

doi:10.1053/joms.2001.20482

Cited by 76 publications

(27 citation statements)

References 25 publications

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“…Hence, multiple osteotomies of the fibula to confirm to the maxilla and mandible are feasible without devascularising individual segments. Moreover FFF offers tremendous bicortical bone stock for dental implant placement and a versatile cutaneous unit for concomitant soft tissue reconstruction [2][3][4][5][6][7][8][9]. Also FFF based on separate septocutaneous perforators is of benefit to extensive substitution to externally cutaneous and internally oral linings [10].…”

Section: Introductionmentioning

confidence: 99%

Versatility of Fibula Free Flap in Reconstruction of Facial Defects: A Center Study

Shroff

Nair

Shah

et al. 2016

J. Maxillofac. Oral Surg.

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Purpose To study a series of cases where vascularised fibula flap was used in various combinations of bone with muscle and skin along with its modifications for reconstruction of simple and composite defects of the facial region. Patients and MethodsThe investigators designed a retrospective study composed of patients with any pathology or defect who underwent reconstruction of maxilla or mandible with vascularised fibula free flap from 2009 to 2013. All patients were evaluated for age, gender, location and type of defect, incorporation of adjoining skin paddle and muscle, number of fibula osteotomies, ischaemia time, anticoagulant regimen, length of hospital stay, flap failure rate, dental implant rehabilitation. All patients with a minimum follow-up of 3 months post-operatively, were included in this study. Results The study sample composed of 30 patients with average age of 39.5 years. Immediate reconstruction was done in 86.66 % of patients. 93.1 % were mandibular reconstructions. In 40 % of patients, the fibula was double barrelled. Skin island was included with the fibula in 20 % of patients. 10 % patients underwent dental rehabilitation using implants with 6.66 % requiring distraction osteogenesis of the fibula which was not required with double barrel reconstructions. Hematoma at the recipient site was the commonest post-operative complication, although its frequency was low. A significant donor site morbidity of around 3.33 % was seen. Average stay in hospital was about 7 days. Post-operatively all patients ambulated normally and none used assisted devices. A reconstruction plate was used to achieve the ideal contour of the jaw in most cases. Aesthetic results were usually good, especially in young patients. The overall success rate was 93.33 %. Conclusion The fibula has many assets which make it the ideal choice for bony reconstruction of facial skeleton and adjoining soft tissue with predictable results.

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Section: Introductionmentioning

confidence: 99%

Versatility of Fibula Free Flap in Reconstruction of Facial Defects: A Center Study

Shroff

Nair

Shah

et al. 2016

J. Maxillofac. Oral Surg.

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“…This includes not only the bone and skin but potentially also the tongue, floor of the mouth, lips, cheeks, mental, and submental regions. The fibula is well suited for this type of reconstruction because it provides the greatest bone length, can be contoured using multiple osteotomies for reconstruction of the shape of the arch, is very suitable for accepting dental implants, and can be harvested with a skin flap for reconstruction of mucosa, skin, or tongue defects [4].…”

Section: Discussionmentioning

confidence: 99%

“…Many reconstructive options exist due to the development of new techniques and the variety of flap donor sites [4,6,18,24]. However, the most common donor site remains to be the fibula [4,6,14,23].…”

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confidence: 99%

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Retrospective analysis and clinical evaluation of mandible reconstruction with free fibula flap

et al. 2006

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The objective of this investigation was to evaluate the indications for and the functional and cosmetic results of mandible reconstruction using free vascularized fibular flaps. It was also designed to assess the patients' quality of life, daily activities, and self-esteem, with special emphasis on patient satisfaction. We conducted a retrospective chart review of all patients who underwent osseus or osteocutaneous free flap reconstruction of the mandible over a 10-year period (1992)(1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002). Those in whom a vascularized fibular flap was used were included in the study and invited for a follow-up comprehensive physical examination and x-ray evaluation. A questionnaire was also administered to evaluate patient satisfaction. Twenty-six patients were included in the study. Fourteen patients died after an average of 2 years and 9 months postoperatively due to their prognosis despite surgical intervention and adjuvant therapy. Of the remaining 12 patients, 6 appeared for the follow-up evaluation, 2 were unavailable for followup, and 4 denied participating. Of these 6 patients, all experienced a decrease in pain and were satisfied with their results. At the time of the latest follow-up, they experienced some difficulties swallowing, and in 3 patients, their articulation was impaired. All 6 patients would undergo the procedure again. Reconstruction of the mandible using a vascularized fibular graft produces satisfactory functional and cosmetic results. In benign lesions, the procedure is highly indicated. However, in the case of malignancy, most patients do not survive their primary tumor. Given the patients limited life expectancy, the improvement in their quality of life as a result of the improved appearance and function of the reconstructed mandible needs to be weighed against the potential morbidity of the operative intervention on an individual basis.

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“…Le greffon microanastomosé de fibula a été utilisé pour reconstituer la mandibule pour la première fois par Hidalgo en 1989 [2] . La fibula est un os cortical, triangulaire dont la section, variant de 10 à 13 mm, autorise la mise en place d'implants [3] . Cette étude se propose d'évaluer les résultats de la mise en place d'implant sur un greffon de fibula, notamment après radiothérapie cervico-faciale.…”

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Réhabilitation sur implants après reconstruction mandibulaire par greffon de fibula microanastomose : une série de 10 cas

Bodard

Gourmet

2005

Med Buccale Chir Buccale

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RÉSUMÉObjectifs : L'utilisation du greffon de fibula microanastomosé a transformé les possibilités de réhabilitation prothétique après mandibulectomie interruptrice. Son volume, sa faible résorption et ses taux de succès permettent d'envisager la mise en place d'implants dentaires supportant une prothèse adjointe ou conjointe. Méthode : Cette série comporte 10 patients ayant bénéficié d'une reconstruction mandibulaire par lambeau de fibula microanastomosé, puis de la mise en place d'implants, et enfin d'une réhabilitation prothétique. Résultats : Sur les 10 patients, 8 ont été traités pour un carcinome épidermoïde des voies aéro-digestives supérieures, 1 pour une histiocytose X et 1 pour un granulome à cellules géantes. 29 implants ont été mis en place ; 1 a été perdu. 2 patients ont été réhabilités par prothèse conjointe, les 8 autres par prothèse adjointe. Le recul clinique varie de 9 à 61 mois. Discussion : Le délai entre la greffe et la mise en place des implants est de 11 à 21 mois ; selon les auteurs le délai recommandé varie de 4 à 24 mois. L'épaisseur des tissus mous oblige à choisir des piliers très longs ; une prolifération tissulaire autour des piliers implantaires peut être observée. Conclusion : Cette série constitue une approche positive des possibilités de réhabilitation supra-implantaire sur lambeau de fibula microanastomosé, permettant le rétablissement des fonctions buccales et l'esthétique faciale, constituant une étape essentielle pour améliorer la qualité de vie des patients.

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Vascularized free fibular flap for mandibular reconstruction: A report of 26 cases

Cited by 76 publications

References 25 publications

Versatility of Fibula Free Flap in Reconstruction of Facial Defects: A Center Study

Versatility of Fibula Free Flap in Reconstruction of Facial Defects: A Center Study

Retrospective analysis and clinical evaluation of mandible reconstruction with free fibula flap

Réhabilitation sur implants après reconstruction mandibulaire par greffon de fibula microanastomose : une série de 10 cas

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