Journal of Surgery

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Vascularized Free Fibula Flap for Reconstruction of Mandibular Defects

Received: 16 May 2014    Accepted: 09 June 2014    Published: 14 June 2014
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Abstract

Objective: To assess the versatility of vascularized free fibula flap in reconstruction of various defects of mandible. Study Design: Prospective study. Duration of Study: March 2009 to March 2012. Methodology: The study group consisted of 10 patients who underwent resection of mandible for various reasons and reconstruction of continuity defects using a vascularized free fibular flap. The mandible was resected for ameloblastoma in 4 cases, squamous cell carcinoma in 1 case, odontogenic keratocysts in 3 cases and ossifying fibroma in 2 cases. The type of reconstruction performed was primary in 9 patients in which osseous fibula flap was used and secondary in 1 patient in which osseocutaneous flap was used. Results: There were 10 patients which include 5 males and 5 females within age group of 20 to 50 years with mean age of 35 years. All flaps survived except in 1 patient who had donor site morbidity. Flap perfusion was seen immediately after anastomosis and was maintained throughout the follow-up period of minimum 6 months. All patients were kept in nasogastric feeding for 5 days and then began oral feeding and walking with some aid in 2nd week and became completely ambulant in 4th week postoperatively. Conclusion: In our study, we conclude that vascularized free fibula flap is a versatile option for reconstruction of large mandibular defects with its good quality and quantity of bone and ease of manipulation to restore the original anatomy of the mandible and permit implant based prosthetic rehabilitation.

DOI 10.11648/j.js.s.2014020601.11
Published in Journal of Surgery (Volume 2, Issue 6-1, December 2014)

This article belongs to the Special Issue Craniofacial Surgery

Page(s) 1-5
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Fibula Reconstruction, Ameloblastoma, Odontogenic Keratocysts

References
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[2] Douglas ar, ariyan s, restifo r: use of the operating microscope and loupes for head and neck free microvascular tissue transfer: arch otolaryngol head neck surg 2003: 129.
[3] Rosenthal e, carroll w, dobbs m, wax m, peters g. Simplifying head and neck micro-vascular reconstruction. Head neck 2004; 26:930-6.
[4] Hidalgo da, rekow a. Review of 60 consecutive fibula free flaps for mandible reconstruction. Plast reconstr surg 1995; 96:585-96;discussion 597-62
[5] Hidalgo da. Fibula free flap: a new method for mandible reconstruction. Plast reconstr surg 1989; 84:71-9.
[6] Dean ad, casapi n, regev e, zeltser r: reconstruction of the mandible by fibula free flap: imaj 2002;4:600-602
[7] Blackwell ke: donor site evaluation for fibula free flap transfer: american journal of otolatyngology 1998;19: 89-95
[8] Daniel tr, thomas r, bell th, neligan pc. Functional outcome of the foot and ankle after free fibula graft. Foot ankle int 2005; 26:597-601
[9] Stephen s, mark a , gregory p, michael j, gregory rd, geoffrey l : choice of flap and incidence of free flap success: american society of plastic surgeons 1996: 98 : 459-463.
[10] Smolka k, kraehenbuehl m, eggensperger n: fibula free flap reconstruction of the mandible in cancer patients: evaluation of a combined surgical and prosthodontic treatment concept: oral oncol 2007:10:10-16.
[11] Nicolic z, jeremic j, milosavjevic r. [use of free microvascular flaps in the management of the head and neck defects]. Vojnsanit pregl 2006; 63:713-20. Serbian
[12] Sieg p, zieron jo, bierwolf s, hakim sg : defect-related variations in mandibular reconstruction using fibula grafts: british journal of oral and maxillofacial surgery 2002: 40, 322–329
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[17] Wolff kd, ervens g, herzog k, hoffmeister b: experience with the osteocutaneous fibula flap: an analysis of 24 consecutive reconstructions of composite mandibular defects: j cranio-maxillofacial surgerv 1996 24, 330-338
[18] Wolff kd, holzle f, eufinger h: the radial forearm flap as a carrier for the osteocutaneous fibula graft in mandibular reconstruction: int j oral maxillofac surg 2003; 32: 614–618.
[19] Neal df, wadsworth jt, villaret d, farwell dg : midface reconstruction with the fibula free flap: arch otolaryngol head neck surg. 2002;128:161-166
[20] Garrett a, ducic y, athre rs, motley t, carpenter b. Evaluation of fibula free flap donor site morbidity. Am j otolaryngol 2006; 27:29-32.
[21] Babovic s, jhonson ch, finical sj. Free fibula donor-site morbidity: the mayo experience with 100 consective harvests. J reconstr microsurg 2000; 16:107-10.
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Author Information
  • Dept of Oral & maxillofacial surgery, NMCH, Nellore, India

  • Dept. of Neurosurgery, NMCH, Nellore, India

  • Dept of Oral & maxillofacial surgery, Index dental college, Indore, M.P., India

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  • APA Style

    Mohammad Akheel, Suryapratap Singh Tomar, Anuj Bhargava. (2014). Vascularized Free Fibula Flap for Reconstruction of Mandibular Defects. Journal of Surgery, 2(6-1), 1-5. https://doi.org/10.11648/j.js.s.2014020601.11

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    ACS Style

    Mohammad Akheel; Suryapratap Singh Tomar; Anuj Bhargava. Vascularized Free Fibula Flap for Reconstruction of Mandibular Defects. J. Surg. 2014, 2(6-1), 1-5. doi: 10.11648/j.js.s.2014020601.11

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    AMA Style

    Mohammad Akheel, Suryapratap Singh Tomar, Anuj Bhargava. Vascularized Free Fibula Flap for Reconstruction of Mandibular Defects. J Surg. 2014;2(6-1):1-5. doi: 10.11648/j.js.s.2014020601.11

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  • @article{10.11648/j.js.s.2014020601.11,
      author = {Mohammad Akheel and Suryapratap Singh Tomar and Anuj Bhargava},
      title = {Vascularized Free Fibula Flap for Reconstruction of Mandibular Defects},
      journal = {Journal of Surgery},
      volume = {2},
      number = {6-1},
      pages = {1-5},
      doi = {10.11648/j.js.s.2014020601.11},
      url = {https://doi.org/10.11648/j.js.s.2014020601.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.js.s.2014020601.11},
      abstract = {Objective: To assess the versatility of vascularized free fibula flap in reconstruction of various defects of mandible. Study Design: Prospective study. Duration of Study: March 2009 to March 2012. Methodology: The study group consisted of 10 patients who underwent resection of mandible for various reasons and reconstruction of continuity defects using a vascularized free fibular flap. The mandible was resected for ameloblastoma in 4 cases, squamous cell carcinoma in 1 case, odontogenic keratocysts in 3 cases and ossifying fibroma in 2 cases. The type of reconstruction performed was primary in 9 patients in which osseous fibula flap was used and secondary in 1 patient in which osseocutaneous flap was used. Results: There were 10 patients which include 5 males and 5 females within age group of 20 to 50 years with mean age of 35 years. All flaps survived except in 1 patient who had donor site morbidity. Flap perfusion was seen immediately after anastomosis and was maintained throughout the follow-up period of minimum 6 months. All patients were kept in nasogastric feeding for 5 days and then began oral feeding and walking with some aid in 2nd week and became completely ambulant in 4th week postoperatively. Conclusion: In our study, we conclude that vascularized free fibula flap is a versatile option for reconstruction of large mandibular defects with its good quality and quantity of bone and ease of manipulation to restore the original anatomy of the mandible and permit implant based prosthetic rehabilitation.},
     year = {2014}
    }
    

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  • TY  - JOUR
    T1  - Vascularized Free Fibula Flap for Reconstruction of Mandibular Defects
    AU  - Mohammad Akheel
    AU  - Suryapratap Singh Tomar
    AU  - Anuj Bhargava
    Y1  - 2014/06/14
    PY  - 2014
    N1  - https://doi.org/10.11648/j.js.s.2014020601.11
    DO  - 10.11648/j.js.s.2014020601.11
    T2  - Journal of Surgery
    JF  - Journal of Surgery
    JO  - Journal of Surgery
    SP  - 1
    EP  - 5
    PB  - Science Publishing Group
    SN  - 2330-0930
    UR  - https://doi.org/10.11648/j.js.s.2014020601.11
    AB  - Objective: To assess the versatility of vascularized free fibula flap in reconstruction of various defects of mandible. Study Design: Prospective study. Duration of Study: March 2009 to March 2012. Methodology: The study group consisted of 10 patients who underwent resection of mandible for various reasons and reconstruction of continuity defects using a vascularized free fibular flap. The mandible was resected for ameloblastoma in 4 cases, squamous cell carcinoma in 1 case, odontogenic keratocysts in 3 cases and ossifying fibroma in 2 cases. The type of reconstruction performed was primary in 9 patients in which osseous fibula flap was used and secondary in 1 patient in which osseocutaneous flap was used. Results: There were 10 patients which include 5 males and 5 females within age group of 20 to 50 years with mean age of 35 years. All flaps survived except in 1 patient who had donor site morbidity. Flap perfusion was seen immediately after anastomosis and was maintained throughout the follow-up period of minimum 6 months. All patients were kept in nasogastric feeding for 5 days and then began oral feeding and walking with some aid in 2nd week and became completely ambulant in 4th week postoperatively. Conclusion: In our study, we conclude that vascularized free fibula flap is a versatile option for reconstruction of large mandibular defects with its good quality and quantity of bone and ease of manipulation to restore the original anatomy of the mandible and permit implant based prosthetic rehabilitation.
    VL  - 2
    IS  - 6-1
    ER  - 

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