Near‐total mandibular reconstruction in the absence of microvascular grafts

Abstract

AbstractBackgroundMicrovascular reconstruction is the optimal method of reconstructing the mandible but this is not always a viable option. When such a situation pertains, an alternative can be the use of autologous rib grafting; however in recent years, this technique has seen substantial decline to almost non‐existent for reconstruction of the mandible. This article revisits autologous rib grafting through a case series and outlines the technique and advantages it provides especially when operating in rudimentary conditionsMethodsA total of 14 patients were presented to four surgical missions in Africa with extensive growth of the mandible from ameloblastomas. Mandibular resection was carried out and the area was reconstructed with autologous rib grafting. Appropriate post‐operative care was provided until discharge.ResultsThe cohort of 14 patients included five males and nine females with an average age of 31 years. The main complication encountered was infection seen in four patients at the grafted site and one patient at the donor site. All areas were managed with local measures of wound toilet and oral antibiotics. In only one case was the rib graft affected by infection; however, this did not impact on the final functional or aesthetic outcome for the patient.ConclusionThis article is a reminder that reconstruction by autologous rib grafts remains a viable option and the technique should not be lost to posterity but should remain part of a head and neck surgeon's armamentarium.