Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note

Akashi, Mitsuru; Matsumoto, Kousuke; Takeda, Daisuke; Yamashita, Junya; Yatagai, Nanae; Hashikawa, Kazunobu; Komori, Takahide

doi:10.3390/dj7030065

Cited by 2 publications

(2 citation statements)

References 19 publications

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“…The PGA sheets serve as absorbent organization-reinforcing structures, which are spontaneously absorbed within 4–15 weeks. They have been used as an organization-reinforcing structure in the field of surgery, such as respiratory and oral surgeries, for several years [ 13 , 14 ]. Recently, the usefulness of shielding using PGA sheets for perforated ulcers has been reported not only in post-ESD perforations but also in duodenal ulcer perforations within gastrointestinal endoscopy [ 8 , 10 , 15 ].…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Closure of an Acute Duodenal Perforation Occurring during Endoscopic Ultrasound Using Endoclips and Polyglycolic Acid Sheets with Fibrin Glue

Matsuoka

Kobayashi

Okura

et al. 2021

Case Rep Gastroenterol

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Acute duodenal perforation during endoscopic ultrasound (EUS) is a serious complication. The conventional endoscopic treatment for duodenal perforations such as endoscopic clipping is unsatisfactory; recently, the effectiveness of over-the-scope clipping (OTSC) has been reported. A 91-year-old woman was referred to our hospital with the chief complaint of jaundice. Contrast-enhanced computed tomography showed a 2-cm mass in the pancreatic head; we planned EUS-guided fine-needle aspiration. During exploration for a puncture route from the duodenal bulb using a linear echoendoscope under carbon dioxide insufflation, the duodenal lumen was suddenly filled with blood. A perforation <15 mm was identified in the superior duodenal horn. We attempted an endoscopic closure with multiple endoclips but could not completely close the perforation site. Strips of bioabsorbable polyglycolic acid (PGA) sheets were placed over the gaps between the endoclips with biopsy forceps and fixed in place with fibrin glue, completely covering the perforation site. Two days after the procedure, the perforation site had closed. Nine days later, endoscopic biliary stenting was performed. The patient was diagnosed with pancreatic cancer through bile cytology, and the optimal supportive care for her age was selected. Endoscopic tissue shielding with PGA sheets and fibrin glue is increasingly being reported for use during gastrointestinal endoscopic procedures. In this case, surgery was avoided due to successful endoscopic treatment using endoclips and PGA sheets with fibrin glue without OTSC. This method may be useful for repairing acute duodenal perforations during EUS and should therefore be known to pancreatobiliary endoscopists.

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Section: Discussionmentioning

confidence: 99%

Endoscopic Closure of an Acute Duodenal Perforation Occurring during Endoscopic Ultrasound Using Endoclips and Polyglycolic Acid Sheets with Fibrin Glue

Matsuoka

Kobayashi

Okura

et al. 2021

Case Rep Gastroenterol

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“…FFFs are suitable for both mandible reconstruction and dental implants [2]. Dental rehabilitation with implant-supported prostheses on fibula bone grafts has high survival rates and few complications [1,3]. However, facial soft tissue contraction and atrophy of the fibula bone itself can result in unaesthetic effects and distortion of the repaired functional occlusion [4,5].…”

Section: Introductionmentioning

confidence: 99%

Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction

Lee

Kim

Jang³

et al. 2020

Maxillofac Plast Reconstr Surg

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Background: Fibula free flap mandible reconstruction is the standard procedure after wide resection of the mandible. Establishment and maintenance of normal occlusion are important in mandible reconstruction both intraoperatively and after surgery. However, scar formation on the surgical site can cause severe fibrosis and atrophy of soft tissue in the head and neck region. Case presentation: Here, we report a case of severe soft tissue atrophy that appeared along with scar formation after mandibular reconstruction through the fibular free flap procedure. This led to normal occlusion collapse after it was established, and the midline of the mandible became severely deviated to the affected side that was replaced with the fibula free flap, leading to facial asymmetry. We corrected the malocclusion with a secondary operation: a sagittal split ramus osteotomy on the unaffected side and a sliding osteotomy on the previous fibula graft. After a healing time of 3 months, implants were placed on the fibula graft for additional occlusal stability. Conclusion: We report satisfactory results from the correction of malocclusion after fibula reconstruction using sliding fibula osteotomy and sagittal split ramus osteotomy. The midline of the mandible returned to its original position and the degree of facial asymmetry was reduced. The implants reduced difficulties that the patient experienced with masticatory function.

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Dental Rehabilitation for Free Fibula Flap-Reconstructed Mandible with Scar Contracture: A Technical Note

Cited by 2 publications

References 19 publications

Endoscopic Closure of an Acute Duodenal Perforation Occurring during Endoscopic Ultrasound Using Endoclips and Polyglycolic Acid Sheets with Fibrin Glue

Endoscopic Closure of an Acute Duodenal Perforation Occurring during Endoscopic Ultrasound Using Endoclips and Polyglycolic Acid Sheets with Fibrin Glue

Correction of malocclusion using sliding fibula osteotomy with sagittal split ramus osteotomy after mandible reconstruction

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