Non-vascularized Fibular Cortex Grafts with Osteocutaneous Free Fibula Transfer: A Novel Technique in Midface Reconstruction

Objectives: To present a method to reconstruct the midface using the fibula as both a microvascular free flap and as a free cortex graft. Methods: 22-year-old male presented with bilateral maxillary odonotogenic myxoma. Bilateral total maxillectomy defects were reconstructed using an osteocutaneous fibula free flap. The nasomaxillary buttresses were augmented using free cortex grafts to provide additional soft tissue projection and lateral nasal support. Results: The patient received dental implants at 10 months postoperatively and resumed a normal diet. His midface height, nasal and maxillary projection were adequate. At 36 months post-treatment he has no evidence of disease recurrence or resorption of the free bone grafts. Conclusion: The fibula free flap can be used to provide additional support to a patient’s reconstruction by means of free cortex grafts. The patient has had successful restoration of pyriform aperture, nasal projection, mastication, and dental restoration using a single donor site.

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Donor Site Angiography before Mandibular Reconstruction with Fibula Free Flap

Journal of Craniofacial Surgery ◽

10.1097/00001665-200111000-00021 ◽

2001 ◽

Vol 12 (6) ◽

pp. 608-613 ◽

Cited By ~ 21

Author(s):

Laszlo Seres ◽

Jozsef Csaszar ◽

Erika Voros ◽

Laszlo Borbely

Keyword(s):

Free Flap ◽

Donor Site ◽

Mandibular Reconstruction ◽

Fibula Free Flap

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A Prospective Cohort Study of Fibula Free Flap Donor-Site Morbidity in 157 Consecutive Patients

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e318221dc2a ◽

2011 ◽

Vol 128 (3) ◽

pp. 714-720 ◽

Cited By ~ 70

Author(s):

Adeyiza O. Momoh ◽

Peirong Yu ◽

Roman J. Skoracki ◽

Suyu Liu ◽

Lei Feng ◽

...

Keyword(s):

Cohort Study ◽

Prospective Cohort Study ◽

Free Flap ◽

Prospective Cohort ◽

Donor Site ◽

Donor Site Morbidity ◽

Fibula Free Flap

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Donor site morbidity after vascularized fibula free flap: gait analysis during prolonged walk conditions

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2017.10.006 ◽

2018 ◽

Vol 47 (3) ◽

pp. 309-315 ◽

Cited By ~ 5

Author(s):

N. Hadouiri ◽

D. Feuvrier ◽

J. Pauchot ◽

P. Decavel ◽

Y. Sagawa

Keyword(s):

Gait Analysis ◽

Free Flap ◽

Donor Site ◽

Donor Site Morbidity ◽

Fibula Free Flap ◽

Vascularized Fibula

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Versatility of radial forearm free flap for intraoral reconstruction

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh1506256j ◽

2015 ◽

Vol 143 (5-6) ◽

pp. 256-260 ◽

Cited By ~ 11

Author(s):

Jelena Jeremic ◽

Zivorad Nikolic

Keyword(s):

Free Flap ◽

Donor Site ◽

Free Flaps ◽

Radial Forearm Free Flap ◽

Sphincter Reconstruction ◽

Vein Thrombosis ◽

Single Donor ◽

Radial Forearm ◽

Acceptable Method ◽

Palmaris Longus Tendon

Introduction. The radial forearm free flap has an important role in reconstruction of the oncologic defects in the region of head and neck. Objective. The aim was to present and evaluate clinical experience and results in the radial forearm free transfer for intraoral reconstructions after resections due to malignancies. Methods. This article illustrates the versatility and reliability of forearm single donor site in 21 patients with a variety of intraoral oncologic defects who underwent immediate (19 patients, 90.5%) or delayed (2 patients, 9.5%) reconstruction using free flaps from the radial forearm. Fascio-cutaneous flaps were used in patients with floor of the mouth (6 cases), buccal mucosa (5 cases), lip (1 case) and a retromolar triangle (2 cases) defects, or after hemiglossectomy (7 cases). In addition, the palmaris longus tendon was included with the flap in 2 patients that required oral sphincter reconstruction. Results. An overall success rate was 90.5%. Flap failures were detected in two (9.5%) patients, in one patient due to late ischemic necrosis, which appeared one week after the surgery, and in another patient due to venous congestion, which could not be salvaged after immediate re-exploration. Two patients required re-exploration due to vein thrombosis. The donor site healed uneventfully in all patients, except one, who had partial loss of skin graft. Conclusion. The radial forearm free flap is, due to multiple advantages, an acceptable method for reconstructions after resection of intraoral malignancies.

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