Abstract
Introduction. The objective of this study was to evaluate a surgical technique and to present the results of delayed reconstruction of palatomaxillary defects using fibula free flap (FFF). Methods. A review was conducted for nine patients who underwent palatomaxillary reconstruction using FFF. Primary disease, type of reconstruction, defect area, fibula segment length and number of osteotomies, radiotherapy, and implant installation after FFF reconstruction were analyzed. Results. All nine patients underwent delayed reconstruction. The fibula shaft was osteotomized into two segments in seven patients and three segments in one patient with bilateral Brown’s revised classification IV/d defect. One case was planned by using a computer-aided design computer-aided manufacturing (CAD/CAM) system with a navigation system. The mean length of the grafted fibula bone was 68.06 mm. Dental implant treatment was performed in six patients. Six patients received radiation therapy, and there were no specific complications related to the radiation therapy. In one case, the defect was reconstructed with FFF flow-through from a radial forearm free flap. Conclusion. This clinical study demonstrated that the fibula flap is an ideal donor-free flap in a palatomaxillary defect. Delayed reconstruction using an FFF can reduce the complication and failure rates.
Highlights
The objective of this study was to evaluate a surgical technique and to present the results of delayed reconstruction of palatomaxillary defects using fibula free flap (FFF)
The purpose of this study was to evaluate the outcomes of palatomaxillary defect reconstruction using the fibula free flap
The previous operation history of resection was maxillectomy in 4 patients, palatal rotation flap with open reduction and internal fixation in 1 patient, maxillectomy with radial forearm free flap in 3 patients, and maxillectomy with rectus abdominis free flap in 1 patient before reconstruction
Summary
The objective of this study was to evaluate a surgical technique and to present the results of delayed reconstruction of palatomaxillary defects using fibula free flap (FFF). Oral and maxillofacial defects after surgical resection of malignant tumors frequently involve the maxilla with the palate This kind of defect can be a result of benign lesion or trauma and include the lining mucosa, teeth, and bone. Maxilla is an essential structure for functions including swallowing, speech, and articulation which are dependent on the integrity of the palatal and alveolar arch [1] Failure to rehabilitate such functions when composing an entire reconstructive planning may result in significant quality of life issues [1]
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