The use of free fibular flap for functional mandibular reconstruction

Peled, Micha; El-Naaj, Imad Abu; Lipin, Yitzhak; Ardekian, Leon

doi:10.1016/j.joms.2004.06.052

Cited by 118 publications

(90 citation statements)

References 22 publications

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“…However, it leads to a huge functional and aesthetic deficit, as well as long-term postoperative complications. (5,6,7) Because radical surgery would possibly increase morbidity by removal of teeth and excision of bone, hence, conservative treatment has been treatment of choice. Shaving and debridement of lesion are parts of conservative treatment.…”

Section: Discussionmentioning

confidence: 99%

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Fibrous Dysplasia of Mandible: A Case Report

Saxena¹,

Ganatra²

2016

jemds

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Craniofacial fibrous dysplasia is one of the three types of fibrous dysplasia that can affect the bones of the craniofacial complex, including the mandible and maxilla. Fibrous dysplasia is a non-neoplastic hamartomatous developmental fibro-osseous lesion of the bone-forming mesenchyme that manifests as a defect in osteoblastic differentiation and maturation. It is a lesion of unknown aetiology, uncertain pathogenesis, and diverse histopathology. Fibrous dysplasia represents about 5% of all bone tumours and over 7% of all benign tumours of body. Monostotic fibrous dysplasia of the mandible is an unusual manifestation of the disease that is usually benign, occurs in young individuals, and is managed by conservative curettage or debridement. We present a rare case of unilateral fibrous dysplasia of left side of mandible. The clinical diagnostic approach including imaging studies: Orthopantomogram (OPG) and 3D tomography is described. Histological examination served an adjunctive role; however, the final diagnosis was obtained after excision of the swelling and confirming it by histopathological examination and it was diagnosed as benign fibrous dysplasia.

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Section: Discussionmentioning

confidence: 99%

“…Bisphosphonates are used in cases when an intervention is necessary but the surgery cannot be performed. (6,7) Treatment of mandibular defects is complex and includes free vascularised flaps. Donor areas involve the iliac crest, radius, scapula and fibula.…”

Section: Discussionmentioning

confidence: 99%

Fibrous Dysplasia of Mandible: A Case Report

Saxena¹,

Ganatra²

2016

jemds

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“…[7][8][9][10][11][12][13][14] The primary advantages of this donor site include: available length of bone, associated soft tissues available, near anatomic dimension, ability to accept bicortical implants and relatively low donor site morbidity. The ability to harvest the flap concurrent with the resection procedure optimizes case flow and minimizes length of procedure.…”

Section: Choice Of Vascularized Bone Flaps and Relative Meritsmentioning

confidence: 99%

18 Reconstruction of the Mandible

Werning¹

2007

Oral Cancer: Diagnosis, Management, and Rehabilitation

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Segmental mandibulectomy leads to a great deÞ cit in the form and function of the patient. Vascularised bone ß aps have become the choice of the method of reconstruction of the mandible in an oncologic setting. Fibula osseous or oseteocutaneous ß aps have become the favored method in centers across the world. This article reviews certain pertinent and practical points with regards to Þ bula ß ap reconstruction of the mandible. Methods of osteosynthesis, merits of inclusion of the FHL muscle in the ß ap and use of osteointegrated implants are discussed in detail. The reader will also be able at the end to understand the role of pre operative vascular imaging, steps taken when there is an irreversible ß ap failure and steps to maintain and rehabilitate occlusion as practiced in the author's service. KEY WORDS Fibula ß ap, mandibular reconstructionFree full text on www.ijps.org

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“…Many different approaches have been used to try to reconstruct these defects [6,13,14,16,18,20,21]. They include the use of alloplastic materials, nonvascularized bone grafts, and vascularized bone transfers.…”

mentioning

confidence: 99%

“…However, the most common donor site remains to be the fibula [4,6,14,23]. In this study, we reviewed our experience with the reconstruction of the mandible using a free vascularized fibula flap.…”

mentioning

confidence: 99%

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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The use of free fibular flap for functional mandibular reconstruction

Cited by 118 publications

References 22 publications

Fibrous Dysplasia of Mandible: A Case Report

Fibrous Dysplasia of Mandible: A Case Report

18 Reconstruction of the Mandible

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

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