title: Deep circumflex iliac artery flap combined with a costochondral graft for mandibular reconstruction.
abstract: Our aim was to use the deep circumflex iliac artery (DCIA) flap together with a costochondral graft as a safe and reliable bone flap for routine reconstruction of the mandibular body and the temporomandibular joint (TMJ). Five patients with benign tumours of the mandible had segmental mandibulectomy including the condyle, and this was reconstructed in one stage using the DCIA combined with a constochondral graft. The rib was inserted into the iliac crest as a whole transplant, and fixed to the proximal stump of the mandible with a prebent reconstruction plate according to a computer-aided design. The grafts healed uneventfully, and dental implants were inserted in 4 cases. During the 2-year follow-up these patients had good mandibular function, including mouth opening, force of bite, and occlusion. The radiographs showed good bony consolidation between the graft and the stump of the mandible and function of the TMJ. A DCIA flap combined with a costochondral graft is a safe and reliable way to provide not only a large bulk of bone to suit the mandible, but also good function of the TMJ in the absence of radiotherapy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, College of Stomatology, Shanghai JiaoTong University, School of Medicine, China. Xingzhou_q@yahoo.com.cn
authors.forename: Qu
authors.initials: Q
authors.lastname: Xingzhou
authors.forename: Zhang
authors.initials: Z
authors.lastname: Chenping
authors.forename: Zhong
authors.initials: Z
authors.lastname: Laiping
authors.forename: Ruan
authors.initials: R
authors.lastname: Min
authors.forename: Zhou
authors.initials: Z
authors.lastname: Shanghui
authors.forename: Wang
authors.initials: W
authors.lastname: Mingyi
mesh_terms: D000293:Adolescent; D000328:Adult; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D017076:Computer-Aided Design; D005260:Female; D006801:Humans; D007083:Iliac Artery / Q000601:surgery*; D007085:Ilium / Q000601:surgery; D021621:Imaging, Three-Dimensional; D007601:Jugular Veins / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery*; D008335:Mandibular Condyle / Q000601:surgery; D008339:Mandibular Neoplasms / Q000534:rehabilitation* / Q000601:surgery; D008341:Mandibular Prosthesis; D008875:Middle Aged; D008953:Models, Anatomic; D019647:Oral Surgical Procedures / Q000379:methods; D011474:Prosthesis Design; D019651:Plastic Surgery Procedures / Q000379:methods; D012272:Ribs / Q000601:surgery; D013524:Surgical Flaps; D013704:Temporomandibular Joint / Q000601:surgery; D055815:Young Adult