title: Long-term results of partial double-barrel vascularized fibula graft in symphysis for extensive mandibular reconstruction.
abstract: OBJECTIVE
  This study aimed to retrospectively review patients who underwent reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis.
  
  
  METHODS
  Ten patients who underwent reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis (n = 6) and partial double-barrel vascularized fibula graft in the symphysis combined with condylar prosthesis (n = 4) were reviewed. Five patients accepted secondary implantation postoperatively. Measurements of chin labial angle on lateral cephalograms and bone height on panoramic radiographs were performed at 2 years postoperatively in 8 patients. Measurements of chin labial angle were compared with preoperative values. Bone height measurements were compared with measurements obtained preoperatively and at 1 month postoperatively. Eight patients with follow-up greater than 2 years were also asked to rate their satisfaction with their facial appearance.
  
  
  RESULTS
  The mean follow-up period was 43.0 months. Bony union and wound healing were observed in all patients during the follow-up period. There was no significant difference in the mean chin labial angle between preoperative measurements and measurements at 2 years postoperatively (P = .128). There was no significant difference in mean bone height between 1 month postoperatively and 2 years postoperatively (P > .05). Eight patients reported that their facial appearance was excellent or good at 2 years postoperatively.
  
  
  CONCLUSIONS
  Reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis could not only achieve good facial appearance and function but also maintain soft and hard tissue stability in the long term.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Shen
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Jun
authors.initials: J
authors.lastname: Li
authors.forename: Jun
authors.initials: J
authors.lastname: Shi
authors.forename: Andrew
authors.initials: A
authors.lastname: Ow
mesh_terms: D000328:Adult; D016025:Bone Transplantation / Q000379:methods*; D002508:Cephalometry; D002680:Chin / Q000473:pathology; D004954:Esthetics; D005260:Female; D005360:Fibula / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007595:Joint Prosthesis; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible / Q000473:pathology; D008335:Mandibular Condyle / Q000601:surgery; D008336:Mandibular Diseases / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods; D010347:Patient Care Planning; D017060:Patient Satisfaction; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D020858:Tissue and Organ Harvesting / Q000379:methods; D055815:Young Adult