The use of free fibular flap for functional mandibular reconstruction.
OBJECTIVE
The purpose of this investigation is to document our experience using the free vascularized fibular flap for comprehensive reconstruction of discontinuity defects in the mandible, after combined resections of malignant and aggressive odontogenic tumors, with special emphasis on functional aspect of the reconstruction process.


METHODS
The study group consisted of consecutive patients treated for reconstruction of discontinuity defects of the mandible, using the fibular vascularized free flap, between 1997-2002. All procedures were performed in the same hospital and by the same surgical team.


RESULTS
A total of 13 patients (9 males, 4 females) were treated in our department in a period of 6 years for reconstruction of discontinuity mandibular defects using the free fibula vascularized flap. Wound healing disturbances at the donor site occurred in 4 cases. Two flaps were lost, 1 because of total failure in a patient who was heavily irradiated because of osteosarcoma, the other because of resorption of the bone tissue transfer in a case of total avulsion of the mandible caused by a fall from height.


CONCLUSIONS
Fibula free vascularized flap is a safe and reliable method for comprehensive functional and esthetic mandibular defect reconstruction. Our protocol has a significant impact on preserving the patients quality of life.
Peled
Micha
M
Department of Oral and Maxillofacial Surgery, Rambam Medical Center, Haifa, Israel.
El-Naaj
Imad Abu
IA
Lipin
Yitzhak
Y
Ardekian
Leon
L
D000293:Adolescent; D000328:Adult; D000368:Aged; D000564:Ameloblastoma / Q000534:rehabilitation / Q000601:surgery; D016025:Bone Transplantation / Q000379:methods; D002280:Basal Cell Carcinoma / Q000534:rehabilitation / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000534:rehabilitation / Q000601:surgery; D003758:Dental Implantation, Endosseous; D019094:Dental Prosthesis, Implant-Supported; D005260:Female; D005360:Fibula / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D008875:Middle Aged; D019647:Oral Surgical Procedures / Q000379:methods*; D010025:Osteoradionecrosis / Q000534:rehabilitation / Q000601:surgery; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply