New modified free chimeric fibular flap design for head and neck reconstruction.
BACKGROUND
The free fibular osteocutaneous flap is a commonly used flap for mandible and buccal mucosa reconstruction in head and neck cancer surgery. However, the skin paddle restriction from the intermuscular septum often limits the soft tissue reconstruction.


METHODS
We have proposed a new modified chimeric fibular osteocutaneous flap design based on the combination of a traditional fibular flap and a peroneal artery perforator fasciocutaneous flap to overcome the restriction from intermuscular septum.


RESULTS
We successfully applied this modified chimeric free fibular osteocutaneous flap design to 2 patients after buccal cancer wide excision surgery.


CONCLUSIONS
The modified free chimeric fibular flap can be easily applied to a segmental defect over the mandible and adjacent soft tissue without restrictions between the bone and the skin paddle. Furthermore, this skin paddle design can also serve as an extra skin paddle to reconstruct an outer cheek skin defect.
Division of Plastic Surgery, Department of Surgery, National Taiwan University Hospital and College of Medicine, Taipei, Taiwan.
Tyng-Luen
TL
Roan
Shyue-Yih
SY
Horng
Jung-Hsien
JH
Hsieh
Hao-Chih
HC
Tai
Hsiung-Fei
HF
Chien
Yueh-Bih
YB
Tang
D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery*; D058752:Free Tissue Flaps; D006258:Head and Neck Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D000077195:Squamous Cell Carcinoma of Head and Neck