[One-stage reconstruction of bilateral mandibular with free fibula flap].
OBJECTIVE
To explore the method of clinical application and the efficacy of free fibula osteomyocutaneous flap in one-stage reconstruction of transmidline bilateral mandibular defect caused by giant neoplasms.


METHODS
From july 2000 to october 2002, transmidline bilateral mandibular defects caused by ameloblastoma (4 cases) and gingival carcinoma (2 cases), according to the character of defects, were reconstructed with free fibula osteomyocutaneous flaps. Peroneal artery and vein were used as vascular pedicle, the fibula was reshaped, and micro-titanium plates were used in rigid fixation between fibula and residue of bilateral mandible. Microvascular anastomoses were carried out between peroneal artery/vein and small artery/vein in neck.


RESULTS
Six free fibular osteomyocutaneous flaps survived well. Follow up duration ranged from 6 months to 2 years, the lower face appearance recovered well, occlusion relationship were normal, all patients were satisfactory with appearance and chewing function after repair of removable denture.


CONCLUSIONS
Free fibular osteomyocutaneous flap is a favorable material in the reconstruction of transmidline bilateral mandibular giant defect. The blood supplement of fibula is offered both by segmentral periosteum and nutrient artery from bone marrow, It is greatly benefit to reshaping as arched mandible.
Li
Jin-song
JS
Center of Cranio-Maxillofacial-Surgery, The Second Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510120, China.
Chen
Wei-liang
WL
Pan
Chao-bin
CB
Wang
Jian-guan
JG
Chen
Shao-wei
SW
Huan
Hong-zhang
HZ
Yang
Zhao-hui
ZH
D000328:Adult; D016025:Bone Transplantation; D005260:Female; D005360:Fibula / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery*; D010027:Osteotomy; D019651:Plastic Surgery Procedures / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome