title: Analysis of functional outcomes in patients with mandible reconstruction using vascularized fibular grafts.
abstract: BACKGROUND
  Although a vascularized fibular graft (VFG) is the favored method for mandible reconstruction, only few functional reports have been published. In this study, surgical outcomes and functional results after mandible reconstruction were analyzed.
  
  
  METHODS
  From 1999 through 2010, oromandibular defects after segmental mandibulectomy were reconstructed with VFG in 101 patients. Operative outcomes and subjective functional evaluation was performed. Of these, 44 patients could be evaluated for functional outcomes, and bite force was measured with an occlusal force meter in 24 patients.
  
  
  RESULTS
  Major surgical complications required secondary revisional surgery developed in four patients. A normal diet was possible in 37 patients (84.1%), and a soft diet was possible in 7 patients (15.9%). Conversational ability was rated as excellent in 42 patients (95.5%). The mean bite force on the nonaffected side of the mandible was 187.7 N, and bite force decreased as the number of osteotomies in the VFG increased. Furthermore, bite force was significantly lower (P = 0.001) on the affected side (58.2 N), compared to nonaffected side (191.9 N).
  
  
  CONCLUSIONS
  Although masticatory force decreases as the number of osteotomies increases, oral function after mandible reconstruction is satisfactory in most cases. Transfer of a VFG is a safe and reliable method for functional mandible reconstruction. © 2015 Wiley Periodicals, Inc. Microsurgery 37:101-104, 2017.
authors.affiliation: Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Sakuraba
authors.affiliation: Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Shimpei
authors.initials: S
authors.lastname: Miyamoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Fujiki
authors.affiliation: Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital, Tokyo, Japan.
authors.forename: Takuya
authors.initials: T
authors.lastname: Higashino
authors.affiliation: Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Azusa
authors.initials: A
authors.lastname: Oshima
authors.affiliation: Department of Head and Neck Surgery, National Cancer Center Hospital East, Kashiwa, Japan.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D001732:Bite Force; D005260:Female; D005360:Fibula / Q000098:blood supply / Q000637:transplantation*; D058752:Free Tissue Flaps / Q000098:blood supply*; D006801:Humans; D008297:Male; D008334:Mandible / Q000503:physiopathology* / Q000601:surgery; D063175:Mandibular Reconstruction / Q000379:methods*; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D010027:Osteotomy; D020127:Recovery of Function; D016896:Treatment Outcome; D055815:Young Adult