The Osteomyocutaneous Free Fibula Flap in Mandibular Reconstruction

Volume 1 - Issue 4

Hyder Ali¹, Sufyan Ahmed²*, Noor ul Wahab³, Huzaifa Saeed ul Khair³ and Muhammad Ashraf Ganatra⁴

Received: April 24, 2018;   Published: May 14, 2018

DOI: 10.32474/IPDOAJ.2018.01.000119

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Abstract

Introduction: Functional reconstruction of mandible is one of the most challenging problems in maxillofacial reconstruction in ablative defects especially after tumour surgery, with the problem becoming complicated after cases of composite tissue resection. Many composite flaps based on microvascular free tissue transfer are now used for functional reconstruction with varying success.

Objectives: To determine the function, cosmesis, and complications of the free fibular flap along with morbidity of the donor site.

Study Design: A descriptive clinical experimental study.

Setting: Department of Plastic & Reconstructive Surgery, Dow University of Health Sciences & Dr Ruth K.M. Pfau Civil Hospital Karachi, Pakistan.

Duration: From January 2015 to December 2017.

Subjects: 15 patients.

Methods: Data was collected through a specially designed preformed, which included a complete history, clinical examination, laboratory investigations and imaging, preoperative findings and postoperative results, complications and follow-up findings. Data was analyzed through SPSS version 21.0.

Results: In this study there were 11 male patients while 4 patients were females. Average age was 46 years (range 23-65 years). In 90% of patients the tumour was Squamous cell carcinoma. “L” segment of mandible was excised in 63%, “C” segment in 20% and “H” segment in 17%. Range of mandibular defect was 7-25cm. Only 2 patients had total flap failure, 2had partial flap failure, plate exposure/extrusion was seen in 1 patient, and major Orocutaneous fistula and donor site dehiscence was noted in 1 patient. Donor site morbidity was low. Restoration of mandibular contour was acceptable in 53.3 % patients. 40% of the patients were able to consume normal diet and 53% of patients were on soft or blended diet. 9 (60%) patients had intelligible sound. Aesthetic result of the flap was good in 50% of the patients, excellent in 23% and fair in 26% of cases.

Conclusion: Osteocutaneous free fibula flap for reconstruction of mandibular defect is a good choice in terms of function, cosmesis, less complications and acceptable donor site morbidity.

Keywords: Osteocutaneous flap; Free flap; Mandibular reconstruction; Oral squamous cell Carcinoma; Free fibular flap

Abbrevations: FFF: Free Fibular Flap; O: Oral; SCC: Squamous Cell Carcinoma

Abstract| Introduction| Materials and Methods| Results| Discussion| Conclusion| Acknowledgement| References|