Stereomodel-assisted fibula flap harvest and mandibular reconstruction.
OBJECTIVE
To describe a method for stereomodel-assisted fibula flap harvest and mandibular reconstruction utilizing multiple fibula bony segments.


METHODS
Stereomodels of the mandible and the fibula were obtained from computed tomography scan data. The length of fibula to be harvested was predetermined by measurement of the stimulated of existing mandibular defect on the mandibular stereomodel. A titanium reconstruction plate was shaped to fit the original mandibular contour. The stereomodel fibula was divided into multiple segments and the segments were placed on the mandibular stereomodel in the ideal edentulous position against the upper dentition and simulate the angular contour of the mandible for best comesis. The predetermined bony segments were measured and the system was then transferred to the patient in the operation theater using acrylic locating splints.


RESULTS
Experience with 8 patients (2 primary and 2 secondary reconstructions) indicated that a good clinical outcome in terms of mandibular contour and positions of the reconstructed segment was possible. The outer facial appearance and symmetry were consistently excellent and no instability or malposition of the graft segments was encountered.


CONCLUSIONS
Stereomodel-assisted fibula flap harvest and insertion is a worthwhile attempt at improving the results of mandibular reconstruction and deserves further attention.
Yeung
Richie W K
RW
Department of Oral and Maxillofacial Surgery, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong. rwkyeung@hkusua.khu.hk
Samman
Nabil
N
Cheung
Lim K
LK
Zhang
Chenping
C
Chow
Raymond L K
RL
D000293:Adolescent; D000368:Aged; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D017076:Computer-Aided Design; D004954:Esthetics; D005260:Female; D005360:Fibula / Q000033:anatomy & histology / Q000601:surgery*; D006801:Humans; D007575:Jaw, Edentulous / Q000473:pathology; D008297:Male; D008334:Mandible / Q000473:pathology; D008339:Mandibular Neoplasms / Q000601:surgery*; D008341:Mandibular Prosthesis; D008875:Middle Aged; D008953:Models, Anatomic; D010347:Patient Care Planning; D019651:Plastic Surgery Procedures / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014025:Titanium; D016896:Treatment Outcome
D014025:Titanium