Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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Reconstruction of Mandible Defect after Tumor Ablation Surgery : Versatility of Fibular Free Flap Design

광범위 종양절제술 후 발생한 하악 결손의 재건 : 결손부위에 따른 비골 유리 피판의 다양한 디자인

  • Seul Chul-Hwan (Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Lee Young-Dae (Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Tark Kwan-Chul (Institute for Human Tissue Restoration, Yonsei University College of Medicine) ;
  • Lew Dae-Hyun (Institute for Human Tissue Restoration, Yonsei University College of Medicine)
  • 설철환 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 이영대 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 탁관철 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소) ;
  • 유대현 (연세대학교 의과대학 성형외과학교실, 인체조직복원연구소)
  • Published : 2005.11.01
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Abstract

Background and Objectives: Fibula is the flap of choice for reconstruction of wide mandible defects after tumor ablation surgery. In mandible reconstruction, restoring the mandible frame to provide mandibular contour and dental arch while restoring masticatory function are important. Even though vascularized fibula can be osteotomized freely, proper design and flap insetting is not easy because of its three dimensional structure and difference in design according to the defect sites. We reviewed patients who underwent mandible reconstruction with fibular flaps according to the defect sites and suggest proper modification methods of fibular flap according to the various defects sites after tumor ablation surgery. Materials and Methods: Twelve consecutive mandible reconstruction with fibular free flaps were performed for defects after tumor ablation surgery. Patients were classified into 4 groups according to the type of mandibular defect(Group 1 : defect on central segment including symphysis, Group 2 : defect on lateral segment(with or without central segment) confined to body, Group 3 : defect on body and ascending ramus that does not include the condyle, Group 4 : defect including the condyle). Results: We suggest different modification methods of fibular free flap for each patient group. Group 1, 3 ; contour by using multiple closing wedge osteotomy. Group 2 ; single or double barrel reconstruction without wedge osteotomy. Group 4 ; contour using single or multiple wedge osteotomy and condylar reconstruction with costochondral graft. Conclusion: Fibular free flaps can be contoured to any desired shape after multiple osteotomies to restore various mandibular defects. It is a reliable and versatile method for reconstruction of mandibular defects after tumor ablation surgery.

Keywords

References

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