PP182: 17 Years – Reconstruction of mandible with microvascular fibula flap and extension of surface contact through stumps fenestration of the posterior surface of the fibula: Variable VI

Abstract

Resection of face’s tumors which involve the face of the maxilla and mandible has left major sequelae. Objective To demonstrate a new technique of reconstruction with the Microvascular fibula flap in mandibular body. Method Study describes a new variation of the technique of reconstruction of the mandible with the microvascular fibula flap by increasing the contact surface between the remaining stump and the bone graft from the fibula in the region of the mandibular angle, which facilitates bone formation.The proposed technique used the osteomyocutaneous microvascular flap from the fibula to reconstruct the mandible. We performed a fenestration in the cortical surface of the end of the fibula, and another in the thickness and width of the ascending branch which is the remainder of the mandible. The ascending branch of the mandible was introduced in the fenestration and fixed with two titanium miniplates and screws respecting the anatomy of the jaws.The external surface of the anterior mandible was accomplished niche compatible with the width and thickness graft of the fibula, which was introduced at the end prepared (1.5 cm in the niche of the remaining stump of the jaw) and fixed with two miniplates and screws. The patient JMK (Erasto Gaertner Oncology Hospital) male, 43 years, caucasian, clinical examination showed an ulcerated lesion infiltrating and floor of mouth and body of the mandible to the left of midline, with histopathological report of squamous cell carcinoma. After submission to pelveglossomandibulectomia and unilateral neck dissection with immediate reconstruction. Results using panoramic radiographs and clinical evaluation, and 10 months after surgery showed function, aesthetics and anatomy of the jaw was restored and released to oral rehabilitation with dental implants. Conclusion It is believed that the described technique can contribute to the return of the function, anatomy of the jaw, conversation and aesthetics.