Oromandibular reconstruction with free fibula osteocutaneous flap after oncologic resection: retrospective analysis of surgical experience and operative outcome of 56 cases

Abstract

Background: Reconstruction of post oncologic resection oromandibular defect is challenging and it provides the base for subsequent radiotherapy and oromaxillary rehabilitation for functional and aesthetic outcome. Multiple reconstructive options including different free flaps exist in the present time of greater awareness, facility and expertise in the field of free tissue transfer surgery. But free fibula osteocutaneous flap (FFOCF) has been the state of art in this area. FFOCF is technically difficult but believed to be reliable even to start with and has a progressively comprehensive surgical technique and learning curve. We are presenting here our experience of FFOCF reconstruction of 56 cases over the last 3 years.Methods: 56 patients operated between 2015 to 2018 were assessed retrospectively for operative and surgical outcome.Results: Flap was successful in 54 (96.43%) cases. Re-exploration was done in 4 cases and was successful in 2 cases. Jaw shape and contour was satisfactory in 70.37% and solid food tolerance was noted in 80.35% cases. Recurrence was seen in 5 cases.Conclusions: FFOCF is a reliable reconstructive option for complex oromandibular defect with a predictable outcome. Flap harvest is reliable and contouring is comprehensive. It gives good functional and aesthetic results with high success rate. Thus this flap is truly the preferred reconstructive option for all type of oncologic oromandibular defect with micro vascular surgery facilities.