Functional outcome in 17 patients whose mandibles were reconstructed with free fibular flaps.
OBJECTIVE
The vascularised free fibular flap is considered to be a reliable choice for reconstruction of oromandibular defects, especially after resection of malignant tumours in the area. This study evaluates the functional outcome of this method.


METHODS
From January 2001 - May 2014, 37 patients were treated at the University Hospital of Linköping using the free fibular flap. The authors present the results from 17. This study reviewed their records and used the University of Washington Quality-of-Life questionnaire (UW-QoL), the Head and Neck Performance Status Scale (PSS), and interviews to assess their outcome.


CONCLUSIONS
Functional evaluation showed a significant decrease in chewing (16 out of 17 patients), appearance (n = 10), salivation (n = 6), sensitivity in the mouth and skin (n = 16), occlusive problems in the mouth (n = 13), and range of mouth opening (n = 12). The remaining domains showed acceptable results, although most of them probably could not compare with the preoperative function. Out of 17 patients, six had to adjust their eating in public significantly, three thought their activity to be considerably restricted and two their recreation to be notably diminished. Common postoperative complications were infections or fistula in the mandible (n = 6), partial or complete rejection of the cutaneous flap (n = 4), and rupture of some of the sutures (n = 3). Nine patients required at least one more operation to repair defects, and six required a new soft tissue flap.
a Department of Plastic Surgery, Hand Surgery and Burns , University Hospital of Linköping , Linköping , Sweden.
Erik
E
Jarefors
a Department of Plastic Surgery, Hand Surgery and Burns , University Hospital of Linköping , Linköping , Sweden.|b Department of Clinical and Experimental Medicine , University Hospital of Linköping , Linköping , Sweden.
Thomas
T
Hansson
D000328:Adult; D000368:Aged; D003680:Deglutition Disorders / Q000209:etiology; D004954:Esthetics; D005260:Female; D005360:Fibula / Q000637:transplantation*; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000601:surgery; D063175:Mandibular Reconstruction; D008409:Mastication; D008875:Middle Aged; D010019:Osteomyelitis / Q000601:surgery; D010025:Osteoradionecrosis / Q000601:surgery; D011183:Postoperative Complications; D011788:Quality of Life; D012086:Reoperation; D012472:Salivation; D013064:Speech Disorders / Q000209:etiology; D013548:Sweden
Free fibular flap; functional outcome; mandible reconstruction