Free Fibula Osteocutaneous Flap for Primary Reconstruction of T3-T4 Gingival Carcinoma

2010 ◽  
Vol 21 (2) ◽  
pp. 301-305 ◽  
Author(s):  
Yue He ◽  
Zhi Yuan Zhang ◽  
Han Guang Zhu ◽  
Robert Sader ◽  
Jie He ◽  
...  
Keyword(s):  
Primary Reconstruction ◽  
Free Fibula ◽  
Osteocutaneous Flap

scholarly journals Salvage Secondary Reconstruction of the Mandible with Vascularized Fibula Flap

2019 ◽  
Vol 12 (4) ◽  
pp. 274-283
Author(s):  
Dinesh Kadam
Keyword(s):  
Soft Tissue ◽  
Tissue Loss ◽  
Successful Outcome ◽  
Primary Reconstruction ◽  
Reconstruction Plate ◽  
Secondary Reconstruction ◽  
Fibula Flap ◽  
Skeletal Defects ◽  
Vascularized Fibula ◽  
Free Fibula

Primary restoration of the mandibular continuity remains the standard of care for defects, and yet several constraints preclude this objective. Interim reconstructions with plate and nonvascular bone grafts have high failure rates. The secondary reconstruction, when becomes inevitable, remains a formidable task. This retrospective study evaluates various issues to address secondary reconstruction. Twenty-one patients following mandibulectomy presented with various complications between 2012 and 2016 were included in the study. The profile of primary reconstruction includes reconstruction plate ( n = 9), reconstruction plate with rib graft ( n = 3), soft tissue only reconstruction ( n = 4), free fibula ( n = 2), inadequate growth of reconstructed free fibula during adolescence ( n = 1), nonvascular bone graft alone ( n = 1), and no reconstruction ( n = 1). All had problems or complications related to unsatisfactory primary reconstruction such as plate fracture, recurrent infection, plate exposure, deformity, malocclusion, and failed fibula reconstruction. All were reconstructed with osteocutaneous free fibula flap with repair of soft-tissue loss. All flaps survived and had satisfactory outcome functionally and aesthetically. Dental rehabilitation was done in four patients. One flap was reexplored for thrombosis and salvaged. The challenges in secondary reconstruction include difficulty in recreating true defects, extensive fibrosis and loss of planes, unanticipated soft-tissue and skeletal defects, reestablishing the contour and occlusion, insufficient bone strength, dearth of suitable recipient vessels, nonpliable skin, tissue contraction to accommodate new mandible, need of additional flap for defect closure, and postirradiation effects. Notwithstanding them, the reasonable successful outcome can be attainable.

scholarly journals Primary free fibula reconstruction in life-threatening haemorrhage from high flow arteriovenous malformation of mandible

2018 ◽  
Vol 51 (02) ◽  
pp. 222-230
Author(s):  
Parvathi Ravula ◽  
Srikanth Rangachari ◽  
Rammurti Susarla ◽  
Laxman Sambari ◽  
Srinivas Saraswathi Jammula
Keyword(s):  
Arteriovenous Malformation ◽  
Curative Resection ◽  
High Flow ◽  
External Carotid ◽  
Primary Reconstruction ◽  
Free Fibula Flap ◽  
Definitive Therapy ◽  
Free Fibula ◽  
Life Threatening ◽  
Selective Embolisation

ABSTRACT Background: High flow arteriovenous malformation (AVM) of the mandible is rare, but it can present as a life-threatening emergency with severe intraoral bleeding for the first time. The gold standard of treatment for an AVM of the mandible is selective embolisation combined with resection and subsequent reconstructions. With the advent of advanced multidisciplinary techniques aimed at definitive therapy, surgical resection and primary reconstruction can provide an ideal anatomical and functional cure. There are no previous reports on primary resection and reconstruction for life-threatening haemorrhage from high flow AVM of the mandible. Aim: We discuss our approach aimed at definitive therapy in life-threatening intraoral bleeding from large high flow AVM of the mandible. Subjects and Methods: Four patients were managed for life-threatening intraoral bleeding during 2015–2017. Compression was applied over the bleeding point before the airway could be secured by endotracheal tube. Under general anaesthesia, the external carotid artery (ECA) was temporarily occluded using an umbilical tape loop ligature to control the bleeding. Emergency selective embolisation was done, followed by curative resection and primary mandible reconstruction using free fibula flap. Outcome assessed. Results: Temporary occlusion of the ECA successfully controlled the bleeding immediately and facilitated selective embolisation and definitive therapy. All the four cases were successfully reconstructed with a good outcome. There was no recurrence during the follow-up period. Conclusion: In life-threatening intraoral bleeding from large high flow AVM of the mandible, emergency selective embolisation followed by curative resection and primary reconstruction is safe in achieving an ideal cure.

Reconstruction of bony mandibular and maxillary defects with one single transfer of a free fibula osteocutaneous flap

2008 ◽  
Vol 61 (2) ◽  
pp. 200-203 ◽  
Author(s):  
Boris Laure ◽  
Florent Sury ◽  
Thomas Martin ◽  
Arnaud Chabut ◽  
Dominique Goga
Keyword(s):  
Free Fibula ◽  
Osteocutaneous Flap ◽  
Maxillary Defects

Rehabilitation of a Bilateral Maxillectomy Patient with a Free Fibula Osteocutaneous Flap and with an Implant-Retained Obturator: A Clinical Report

2015 ◽  
Vol 25 (4) ◽  
pp. 341-348 ◽  
Author(s):  
Takafumi Otomaru ◽  
Yuka I. Sumita ◽  
Yiliyaer Aimaijiang ◽  
Motohiro Munakata ◽  
Noriko Tachikawa ◽  
...  
Keyword(s):  
Clinical Report ◽  
Free Fibula ◽  
Osteocutaneous Flap

Comparison between primary closure and skin grafts of the free fibula osteocutaneous flap donor site

2016 ◽  
Vol 20 (3) ◽  
pp. 233-237 ◽  
Author(s):  
Masaya Akashi ◽  
Kazunobu Hashikawa ◽  
Hiroyuki Takasu ◽  
Kazuhiro Watanabe ◽  
Junya Kusumoto ◽  
...  
Keyword(s):  
Primary Closure ◽  
Donor Site ◽  
Skin Grafts ◽  
Free Fibula ◽  
Osteocutaneous Flap

scholarly journals Radical resection of giant ameloblastoma mandible with free fibula reconstruction: a case report and review of literature

2020 ◽  
Vol 7 (2) ◽  
pp. 602
Author(s):  
Ankit Vishwani ◽  
Kavita Goyal ◽  
Dhirendra Suman ◽  
Vipin Arora ◽  
Suvercha Arya ◽  
...  
Keyword(s):  
Case Report ◽  
Radical Resection ◽  
Neck Surgery ◽  
Needle Aspiration ◽  
Free Fibula Flap ◽  
Facial Disfigurement ◽  
Free Fibula ◽  
Needle Aspiration Cytology ◽  
Osteocutaneous Flap ◽  
Slow Growing

The ameloblastoma is a rare odontogenic tumor of the oral cavity. It is slow growing, locally invasive benign tumor affecting mandible more than maxilla mostly in age group 30-60 years. It grows in bone and soft tissue causing facial disfigurement. Treatment is surgical taking wide margins. This case report describes the treatment of a 30-year-old female having right side jaw swelling since two years, fine needle aspiration cytology was suggestive of ameloblastoma. Right hemi mandibulectomy was done by head and neck surgery team and reconstruction was done by plastic surgery team using free fibula flap. The free fibula osteocutaneous flap is the most versatile and reliable option for microsurgical reconstruction of large mandibular defects.

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