title: Reconstruction of Extended Orbitomaxillectomy and Hemimandibulectomy Defects With Fibula Flaps and Patient-Specific Implants.
abstract: An extended orbitomaxillectomy and hemimandibulectomy for polyostotic juvenile ossifying fibroma resection were performed with the assistance of patient-specific cutting guides. The resulting defects were reconstructed in stages. First, a patient-specific mandibular reconstruction plate was fixed to the hemimandibulectomy defect in the same operation as the resection. After margins were proven to be free of tumor on histologic analysis, a free fibula flap contoured to the reconstruction plate was used to reconstruct the mandible. Reconstruction of the maxilla, alveolus, and orbit were performed with a second free fibula flap and patient-specific implants. The lining of the total nasal vault cavity was reconstructed with septal flaps. At 7 months postoperatively, the patient had an excellent esthetic result and resolved diplopia.
authors.affiliation: From the Department of Plastic Surgery, Loma Linda University, Loma Linda, CA.
authors.forename: Wendy W
authors.initials: WW
authors.lastname: Wong
authors.forename: Mark C
authors.initials: MC
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D001860:Bone Plates; D016025:Bone Transplantation / Q000379:methods*; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery*; D063168:Mandibular Osteotomy / Q000379:methods*; D063175:Mandibular Reconstruction / Q000379:methods*; D008437:Maxilla / Q000601:surgery*