Mandibular reconstruction using vascularized bone graft: indications of fibular flap, scapular flap and iliac crest flap

Latar belakang: Perkembangan teknik pembedahan mikrovaskular telah menghasilkan jabir bebas fibula yang dapat digunakan untuk rekonstruksi oromandibular. Jabir bebas fibula merupakan salah satu jabir tulang yang sering digunakan untuk mengatasi defek pada daerah wajah, terutama dalam rekonstruksi mandibula. Jabir ini memiliki banyak keunggulan dibandingkan dengan jabir tulang lainnya, seperti jabir skapula dan jabir iliaka. Jabir ini memiliki angka kesuksesan yang cukup tinggi yaitu mencapai 95%, namun untuk mencapai angka keberhasilan tersebut diperlukan perencanaan yang tepat sebelum dilakukannya pengambilan jabir mulai dari preoperatif, perioperatif, intraoperatif, dan pascaoperatif. Tujuan: Para ahli THT dapat mengetahui perencanaan yang tepat sebelum melakukan rekonstruksi mandibula. Tinjauan pustaka: Jabir bebas fibula memiliki angka keberhasilan yang tinggi dan merupakan jabir pilihan untukrekonstruksi mandibula. Kesimpulan: Perencanaan yang tepat mulai dari preoperatif sampai pascaoperatif sebelum dilakukan pengambilan jabir bebas fibula sangat diperlukan untuk mendapatkan hasil yang optimal.Kata kunci: Jabir bebas fibula, pembedahan mikrovaskular, rekonstruksi mandibula ABSTRACTBackground: Development in microvascular surgery technique has created a flap that can be used for oromandibular reconstruction. Free fibular flap is one of the bone flaps that frequently use for facial defects, especially mandibular reconstruction. This flap has lots of advantages than other bone flaps, such as scapula flap and iliac crest flap. Free fibular flap has a high successful rate up to 95%, but it needs meticulous planning before harvesting the bone; preoperative, perioperative, intraoperative, and postoperative is needed to get the high successful rate. Purpose: To inform ENT specialists about the appropriate planning before mandibular reconstruction. Literature review: Free fibular flap has a high successful rate and one of the excellent choices for mandibular reconstruction. Conclusion: The right preoperative to postoperative planning before doing the free fibularflap is very important to obtain optimal outcome. Keywords: Free fibular flap, microvascular surgery, mandibular reconstruction

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The Advantages of Vascularized Fibular Bone Graft For Mandibular Tumor Reconstruction

Jurnal Plastik Rekonstruksi ◽

10.14228/jpr.v1i1.31 ◽

1970 ◽

Vol 1 (1) ◽

Cited By ~ 1

Author(s):

Parintosa Atmodiwirjo ◽

Nandita Melati Putri

Keyword(s):

Oral Cavity ◽

Bone Graft ◽

Plastic Surgery ◽

Bone Healing ◽

Mandibular Reconstruction ◽

Surrounding Tissue ◽

Vascularized Bone Graft ◽

Mandibular Tumor ◽

Oral Cavity Tumor ◽

Vascularized Bone

Mandibular reconstruction are often indicated in patient who underwent ablation or excision of the mandible due to malignancy of the oral cavity.In this paper we will discuss about the mandibular reconstruction with use of alloplastic implant, and vascularized bone graft. Four cases of oral cavity tumor which were referred to the plastic surgery division at Cipto Mangunkusumo hospital during 2005-2011, after being diagnosed with oral cavity tumor were re-viewed. Mandibular reconstruction can be done using alloplastic implant, non-vascularized bone graft or vascularized bone graft. In this paper we studied four patients who needed mandibular reconstruction after ablation of oral cavity tumors. Patients who underwent reconstruction with alloplastic implants all had complications such as broken hardware. Where as in patient who underwent free fibular tissue transfer there were no complications at all. We can conclude that in less vascularized surrounding tissue as in cases that received or will receive other treatment such as chemotherapy or radiation that vascularized bone graft are superior. The bone healing in vascularized bone graft also does not depend on creeping substitution like in non vascularized bone graft.

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