Flap Reconstruction Of Mandible Research Articles

Masticatory performance in patients undergoing free fibula flap for mandible reconstruction

BackgroundTo explore the masticatory performance in patients undergoing an osteo(cutaneous) free fibula (OFF) flap for mandible reconstruction by a prospective design.MethodsA total of 56 patients who had undergone OFF flap reconstructions for mandibular reconstruction secondary to malignant (squamous cell carcinoma) or benign (ameloblastoma) tumor resection were prospectively enrolled. They were asked to complete the masticatory performance test by the weigh method and the chew domain of the University of Washington quality of life questionnaire (version 4) preoperatively and at 3, 6, and 12 months postoperatively. The pair nonparametric test was used to analyze the dynamic change of masticatory performance and subjective chew function.ResultsFifty-one patients were included for analysis finally. The mean masticatory performance for patients with malignant tumors were 53.4% ± 10.3%, 36.4% ± 10.3%, 42.6% ± 9.6%, 52.8% ± 10.9%, and 53.1% ± 11.8% preoperatively, at 2 weeks, 3 months, 6 months, and 12 months postoperatively, respectively. Compared with the preoperative level, the masticatory performance had a significant reduction immediately after surgery (p < 0.001), followed by a return to the baseline level within three months. A similar trend was noted for those with benign tumors. The mean score of chew domain for patients with malignant tumors were 100 ± 0, 54.3 ± 32.9, 81.4 ± 24.5, and 92.9 ± 17.8 preoperatively, at 3 months, 6 months, and 12 months postoperatively, respectively. Compared with the preoperative level, the subjective chew function was greatly affected within the first three months (p < 0.001), and it gradually recovered to the baseline level in the following nine months. A similar trend was noted in patients with benign tumors.ConclusionsThe masticatory performance and subjective chew function was significantly affected after OFF flap reconstructions in the short term, but both recovered to the preoperative levels within 9–12 months.

Evaluation of the ankle function following reconstruction of the donor defect with a split fibular bone after a vascularized fibular flap transfer

To validate the hypothesis that the reconstruction of the missing segment of the fibula using a redundant split fibular graft after a vascularized fibular flap transfer may have a better effect on ankle function. Of the 24 head and neck cancer patients who received a free fibula flap for mandible reconstruction, 14 patients underwent the conventional method of donor site closure, in which the redundant fibular bone was discarded (Group I). Ten patients underwent longitudinal osteotomy of the redundant non-vascularized fibular portion to bridge the donor site defect (Group II). Postoperative subjective satisfaction level was evaluated with a self-constructed questionnaire in 10 parameters (ambulation with assistance, ankle instability, ankle stiffness, muscle weakness, leg edema, foot numbness, ankle pain, other sites of pain besides the ankle, and restriction to run) and the 4 voluntary motions (dorsiflexion, plantar flexion, eversion, and inversion) of both ankles were measured using a CYBEX II dynamometer. The muscle peak torque of the donor leg was significantly lower at ankle plantar flexion (P = 0.002), eversion (P = 0.002), and inversion (P = 0.0002) in Group I as well as at dorsiflexion (P = 0.031), plantar flexion (P = 0.016), and inversion (P = 0.002) in Group II against the contralateral non-operated leg. The muscle power was significantly greater when performing ankle eversion (P = 0.049) in those who underwent split fibular bone reconstruction. There was no difference in the subjective satisfaction score between these two groups. The reconstruction of the donor site with a split fibular bone graft led only a slight improvement in ankle eversion.

O.242 Fibula osteomyocutaneous flap for mandible reconstruction

O.242 Fibula osteomyocutaneous flap for mandible reconstruction

Poster 038: The Use of the Fibula Osteomyocutaneous Flap for Mandible Reconstruction: A 15-Year Experience

Poster 038: The Use of the Fibula Osteomyocutaneous Flap for Mandible Reconstruction: A 15-Year Experience

Seizure-Like Activity and Prolonged Central Nervous System Side Effects After Intravenous Sedation

105:2440, 2000 11. Nisanci M, Turegun M, Er E, et al: Reconstruction of the middle and lower face with three simultaneous free flaps: Combined use of bilateral fibular flaps for maxillomandibular reconstruction. Ann Plast Surg 51:301, 2003 12. Zhang C, Zhang Z: Reconstruction of mandible with fibular flap and dental implant distractor: A new approach. Chin Med J 115:1877, 2002 13. Barton FE Jr, Spicer TE, Byrd HS: Head and neck reconstruction with the latissimus dorsi myocutaneous flap: Anatomic observations and a report of 60 cases. Plast Reconstr Surg 71:199, 1983 14. Hayden RE, Kirby SD, Deschler DG: Technical modifications of the latissimus dorsi pedicled flap to increase versatility and viability. Laryngoscope 110:352, 2000 15. Shigemitsu K, Naomoto Y, Haisa M, et al: A case of thyroid cancer involving the trachea: Treatment by partial tracheal resection and repair with a latissimus dorsi musculocutaneous flap. Jpn J Clin Oncol 30:235, 2000 16. Wu LY, Halim AS, Sain AH: Laminated pedicled latissimus dorsi myocutaneous flap for single-stage reconstruction of a composite anterior neck and tracheal defect. J Otolaryngol 34:69, 2005 17. Zbar RI, Funk GF, McCulloch TM, et al: Pectoralis major myofascial flap: A valuable tool in contemporary head and neck reconstruction. Head Neck 19:412, 1997 18. Liu R, Gullane P, Brown D, et al: Pectoralis major myocutaneous pedicled flap in head and neck reconstruction: A retrospective review of indications and results in 244 consecutive cases at Toronto General Hospital. J Otolaryngol 30:34, 2001 19. Vartanian JG, Carvalho AL, Carvalho SM, et al: Pectoralis major and other myofascial/myocutaneous flaps in head and neck cancer reconstruction: Experience with 437 cases at a single institution. Head Neck 26:1018, 2004 20. Wei FC, Chen HC, Chuang CC, et al: Fibular osteoseptocutaneous flap: Anatomic study and clinical application. Plast Reconstr Surg 78:191, 1986 21. Jones NF, Monstrey S, Gambier BA: Reliability of the fibular osteocutaneous flap for mandibular reconstruction: Anatomical and surgical confirmation. Plast Reconstr Surg 97:707, 1996 22. Ferri J, Piot B, Ruhin B, et al: Advantages and limitations of the fibula free flap in mandibular reconstruction. J Oral Maxillofac Surg 55:440, 1997 23. Chang YM, Santamaria E, Wei FC, et al: Primary insertion of osseointegrated dental implants into fibula osteoseptocutaneous free flap for mandible reconstruction. Plast Reconstr Surg 102:680, 1998

Fibula Free Flap for Mandible Reconstruction: Analysis of 30 Consecutive Cases and Quality of Life Evaluation

Fibula Free Flap for Mandible Reconstruction: Analysis of 30 Consecutive Cases and Quality of Life Evaluation

Fibula Osteocutaneous Flap for Mandible Reconstruction after Ameloblastoma Resection: Amending Technique to Reduce Ischaemic Time

A 27-year-old patient with ameloblastoma of the mandible underwent anterior mandibulectomy and reconstruction with left fibula osteocutaneous flap. The bone was shaped at the lower limb before cutting the pedicle. Vascularised free fibula flap provides a good alternative to other bone grafts in mandible reconstruction as it is relatively easy to perform, carries a low complication rate, and mandibular shaping with intact pedicle cuts down on ischaemic as well as total operative time.