Fibular free flaps in the management of osteomyelitis of the mandible

Abstract

Microvascular reconstruction with a fibular free flap should be considered as a treatment option in the management of chronic osteomyelitis of the mandible.

Reconstruction of a pathologic fracture following osteomyelitis of the mandible using a fibula osteocutaneous flap

“…Osteomyelitis of the jaw is defined as inflammation and infection of the cancellous and cortical portion of the maxillary skeleton and was first described by Pell et al in 1955 [ 1 ]. In clinical practice, maxillofacial osteomyelitis is rarely reported, and the incidence has been dramatically decreased since the introduction of antibiotics and improvements in oral hygiene [ 10 ]. Dental extraction, surgical interventions of the mandible, and maxillofacial trauma can be odontogenic causes, and related comorbidities include malnutrition, alcoholism, smoking, diabetes mellitus, hypertension, osteoporosis, and steroid use [ 11 ].…”

“…The basic principle in treating chronic mandibular osteomyelitis is the eradication of pathogenic microorganisms and the removal of all affected tissues. Most cases can be treated with small resections, but in intractable cases, as in our study, wide resection with reconstruction should be performed [ 10 ].…”

The Progress in Reconstruction of Mandibular Defect Caused by Osteoradionecrosis

“…Radiotherapy in the perioperative period is frequently scheduled for patients with head and neck cancer (HNC). Osteoradionecrosis (ORN) is a serious late complication of radiotherapy (RT) for head and neck cancer, which exhibits as exposed, nonviable bone in an irradiated feld, failing to heal spontaneously or by means of conservative treatment in at least 3 months after radiotherapy while being unrelated to tumor recurrence [1][2][3]. Te mandible, playing an important role in facial esthetics and the function of the stomatognathic system, is a predisposed place for ORN [4].…”

Virtual Surgical Planning for Bisphosphonate-Related Osteonecrosis of the Jaw: A Valuable Application in Advanced Cases

“…The fibula has a superior quality of bicortical bone that can support dental implants, a long and reliable pedicle, vessel caliber suitable for microvascular anastomosis, and the presence of abundant skin and muscle that can be utilized for soft tissue reconstruction [6]. FFFs have proven to be particularly valuable in the reconstruction of composite mandibular defects, when it is necessary to shape vascularized bone to maintain facial symmetry and preserve oral function [7].…”