Simultaneous maxillary and mandibular reconstruction with a single Osteocutaneous fibula free flap: A description of three cases

Large defects that comprise both the maxilla and mandible prove to be difficult reconstructive endeavors and commonly require two free tissue transfers. Three cases are presented to discuss an option for simultaneous reconstruction of maxillary and mandibular defects using a single osteocutaneous fi...

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Bibliographic Details
Published inMicrosurgery Vol. 41; no. 1; pp. 79 - 83
Main Authors Krane, Natalie A., Fagin, Adam, Ghanem, Tamer A., Cannady, Steven B., Petrisor, Daniel, Wax, Mark K.
Format Journal Article
LanguageEnglish
Published Hoboken, USA John Wiley & Sons, Inc 01.01.2021
Wiley Subscription Services, Inc
Subjects
Alveolar bone
Biomedical materials
Defects
Fibula
Mandible
Mastication
Maxilla
Muscles
Reconstructive surgery
Rehabilitation
Rhabdomyosarcoma
Trauma
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Summary:Large defects that comprise both the maxilla and mandible prove to be difficult reconstructive endeavors and commonly require two free tissue transfers. Three cases are presented to discuss an option for simultaneous reconstruction of maxillary and mandibular defects using a single osteocutaneous fibula free flap. The first case describes a 16‐year‐old male with a history of extensive facial trauma sustained in a boat propeller accident resulting in a class IId maxillary and 5 cm mandibular defect status post three failed reconstructive surgeries; the second, a 33‐year‐old male with recurrent rhabdomyosarcoma of the muscles of mastication with resultant hemi‐mandibulectomy and class IId maxillary defects; and lastly, a 48‐year‐old male presenting after a failed scapular free flap to reconstruct defects resulting from a self‐inflicted gunshot wound, which included a 5 cm defect of the right mandibular body and 4.5 cm defect of the inferior maxillary bone. In all cases, a single osteocutaneous fibula free flap was used in two bone segments; one to obturate the maxillary defect and restore alveolar bone and the other to reconstruct the mandibular defect. The most recent patient was able to undergo implantable dental rehabilitation. Postoperatively, the free flaps were viable and masticatory function was restored in all patients during a follow‐up range of 2–4 years.
Bibliography:This case series was presented at The Triological Society Combined Sections Meeting in Coronado, CA on January 26, 2019.
ISSN:0738-1085
1098-2752
DOI:10.1002/micr.30652