• Journal of International Society for Simulation Surgery
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• 제3권1호
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• pp.12-15
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• 2016

Functional and esthetic reconstruction after segmental mandibulectomy is one of the most challenging surgeries in microsurgical reconstruction field. Simulation surgery before free flap reconstruction has been performed for efficient surgery and successful results. Fibula free flap is the flap of the choice for reconstruction of the segmental mandibular defect. Straight nature of the fibula bone requires multiple segmentations to fit into mandible. 3D rapid prototype (RP) model gives a lot of information for mandibular reconstruction. The purpose of this study was to report mandibular reconstruction with free fibular flap using simulation surgery. A total of 30 consecutive patients were included for functional and esthetic evaluation. Among 30 patients, two flaps showed necrosis after radiotherapy. The other flaps were all survived and showed successful reconstruction in both function and esthetics.

• 대한두경부종양학회지
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• 제39권1호
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• pp.11-14
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• 2023

The primary treatment of oral cavity cancer is still surgery. By discussing the surgical treatment of oral cavity cancer, the basic concept of head and neck surgery could be thoroughly reviewed. The oral cavity is defined as the hard palate and the anterior 2/3 of the tongue. With appropriate reconstruction, most defects can be repaired without a significant change in quality of life, unlike in the oropharynx or hypopharynx, where aspiration problems frequently occur. The selection of a surgical approach that can provide an appropriate field of view to obtain a resection margin of 5 mm or more has become the core of head and neck surgery. The role of prophylactic neck dissection is also well established in oral cavity cancer patients. Mandibulotomy for access to the oral cavity or mandibulectomy due to cancer invasion requires bony surgical techniques, and reconstruction also requires bone tissue reconstruction techniques as well as soft tissue. Therefore, oral cancer surgery is the most important primary area where all techniques of head and neck surgery are mobilized.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제28권3호
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• pp.231-233
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• 2002

Temporary reconstruction of the mandibular continuity defect resulting from the ablative tumor surgery with a reconstruction plate can be used for the preservation of normal facial contour and oral function and for periodic follow up of recurrence. Reconstruction plates are adapted to the bone before the resection and provisionally fixated with some screws. Accurate contouring and adaptation are very important for the prevention of displacement of bony stumps and decubituous skin ulcer. However, if there is large expanding buccal tumor mass in mandible, it is very difficult or even impossible to contour the plate before resection. I, therefore, introduce the reconstruction plate application technique using a simple condylar repositioning miniplate after segmental mandibular resection.

• Archives of Plastic Surgery
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• 제43권1호
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• pp.3-9
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• 2016

The reconstruction of the mandible is a complex procedure because various cosmetic as well as functional challenges must be addressed, including mastication and oral competence. Many surgical techniques have been described to address these challenges, including non-vascularized bone grafts, vascularized bone grafts, and approaches related to tissue engineering. This review summarizes different modifications of the free vascularized fibula graft, which, since its introduction by Hidalgo in 1989, has become the first option for mandibular reconstruction. The fibula free flap can undergo various modifications according to the individual requirements of a particular reconstruction. Osteocutaneous flaps can be harvested for reconstruction of composite defects. 'Double-barreling' of the fibula can, for instance, enable enhanced aesthetic and functional results, as well as immediate one-stage osseointegrated dental implantation. Recently described preoperative virtual surgery planning to facilitate neomandible remodeling could guarantee good results. To conclude, the free fibula bone graft can currently be regarded as the "gold standard" for mandibular reconstruction in case of composite (inside and outside) oral cavity defects as well as a way of enabling the performance of one-stage dental implantation.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제47권3호
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• pp.216-223
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• 2021

Preoperative patient analysis for oral cancer involves multiple considerations that are based on multiple factors; these include TNM stages, histopathologic findings, and adjacent anatomical structures. Once the decision is made to excise the lesion, the margin of dissection and its extent should be considered along with the best form of reconstruction and airway management. Treatment methods include surgical resection, radiotherapy, and chemotherapy. Although the combined method of treatment is controversial, surgical resection is considered predominantly, and immediate reconstruction after surgical resection follows. The choice of treatment is dictated by the anticipated functional and esthetic results of treatment and also by the availability of a surgeon with the required expertise. Segmental mandibulectomy with primary reconstruction has been shown to have advantages in both functional and esthetic results. A 52-year-old male patient with basaloid squamous cell carcinoma of the floor of the mouth, and the anterior portion of the mandible was treated with surgical procedures that included segmental mandibulectomy with both supraomohyoid neck dissection (SOHND) at Levels I-III and mandible reconstruction with a left fibula free flap. A 55-year-old male patient with clear cell odontogenic carcinoma of the oral cavity underwent segmental mandibulectomy with both SOHND at Levels I-III and mandible reconstruction with a left fibula free flap. The purpose of this study was to review the anatomic and functional results of patients after immediate reconstruction with a fibula free flap following resection of carcinoma in the anterior portion of the mandible and floor of the mouth.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제42권
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• pp.39.1-39.5
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• 2020

Background: Head or scalp injury is a life-threatening and typically accidental human injury. Most medical departments require immediate medical treatment and proper treatment with specialized medical personnel and facilities. However, in low-resource environments, such as the rural region of West Africa, the authors have treated emergency trauma patients and provided immediate treatment despite lack of resources. Case presentation: We reviewed three cases of scalp injury patients, with representative clinical information, and used these cases to outline feedback on scalp trauma treatment based on the specialty knowledge of general and emergency surgeon. Conclusions: Oral and maxillofacial surgeons are medical specialists that can immediately diagnose and treat these scalp injuries based on their medical knowledge and experience with the maxillofacial region.

• 대한치과의사협회지
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• 제49권9호
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• pp.520-526
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• 2011

Vascularized iliac crest flap include bone tissue of good quality and quantity for mandible segmental defect. Even if fibular flap can contain longer bone tissue, iliac crest has esthetic shape for mandible body reconstruction and large height for implant. Conventional vascularized iliac crest osteomyocutaneous flap is too bulky for reconstruction of intraoral soft tissue defect. But modified flap can reduce soft tissue volume, so is good for functional reconstruction of oral mucosa. It takes only one month for completely replace oral mucosa. The final mucosal texture is much better than other skin paddle flap, especially for implant prosthesis. Donor site morbidity of this method looks same level or less with other modalities functionally and socially. In case of oral mucosa-mandible combined defect, vascularized iliac crest with internal oblique muscle flap shows good outcomes for hard and soft tissue.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권1호
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• pp.13-20
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• 2009

Background In contrast to defects of the mandible and mouth floor region, in the defect of maxilla, the availability of firmly attached oral and nasal mucosal linings is needed. In addition to it, in consider of operation field, operating convenience, and esthetics, reconstruction using prelaminated flap is strongly recommended. Therefore we consider the prelaminated flap through the cases that is reconstructed using prelaminated forearm flap and prelaminated scapular flap. Patients and Methods From 2001 to 2008, in OMFS SNUDH, there were 6 cases that had reconstruction using prelaminated forearm free flap and other 3 cases that had reconstruction using prelaminated scapular flap of maxilla. The average age of patients that were reconstructed using prelaminated forearm free flap was 47.5 years, the average prelaminated period (after $1^{st}$ operation ${\sim}$ until $2^{nd}$ operation) was 51.8 days and the average follow-up period after $2^{nd}$ operation was 35.3 months. As well, the average age of patients that were reconstructed using prelaminated scapular free flap was 37 years, the average prelaminated period (after $1^{st}$ operation ${\sim}$ until $2^{nd}$ operation) was 57 days and the average follow-up period after $2^{nd}$ operation was 42.3 months. Results Except 1 case that were reconstructed using prelaminated scapular flap, we could get firmly attached oral and nasal stable skin(mucosal like) lining, more adequate thickness flap than any other flap and improved esthetic and functional results in the other 8 cases that were reconstructed using prelaminated flap. The complications of the prelaminated forearm flap cases were inconvenient swallowing, sputum, limitation of mouth opening and difficult mastication. It came from flap shrinkage of the flap in some aspect, as well as other combined operations such as mass resection or RND. The difficult point of the reconstruction of prelaminated scapular flap was the possibility of vascular damage at preparation of flap in $2^{nd}$ surgery. The damage could cause the failure of the prelaminated scapular flap. And the skin-lining of the prelaminated flap had limitations, so it is needed to study about the cultured oral epithelium-lining flap instead of the skin-lining flap. Conclusion We considered about advantages, complications and notable things of prelaminated flap through maxillary reconstruction cases using prelaminated forearm flap and prelaminated scapular flap so far. Furthermore, we should go on studying for functional reconstruction of prelaminated fasciomucosal flap using cultured oral epithelium.

• Asian Pacific Journal of Cancer Prevention
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• 제13권2호
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• pp.553-558
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• 2012

Purpose: This article reviews a few of the commonly used types of vascularized osseous free flaps in maxillofacial reconstruction, which still represents the gold standard of restoration. We also discuss the developing concepts in maxillofacial reconstruction. Recent findings: Most of the literature reconfirms the established patterns of reconstruction with the aid of vascularized osseous free flaps. This method of free-tissue transfer is also feasible in cases of osteoradionecrosis or bisphosphonate-related osteonecrosis of the jaw. These flaps are also suitable for prosthetic restoration using osseointegrated dental implants. Summary: Vascularized osseous free flaps still remain the standard of care. Improvements upon the free-tissue transfer method employing vascularized osseous free flaps, such as distraction osteogenesis, tissue engineering, and imaging techniques, currently require further development, but these technologies could lead to improved outcomes of maxillofacial reconstruction in the near future.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제44권5호
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• pp.207-211
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• 2018

Among different graft materials for craniofacial reconstruction, calcium phosphate cements have the advantages of alloplastic grafts and wide use. The authors report a case of foreign body reaction following frontal reconstruction with JectOS (an injectable calcium orthophosphate cement; Kasios) and reviewed the literature on complications of this material after craniofacial reconstruction from 2002 to 2017. Complications were categorized into two groups: immunologic reactions (consisting of seroma collection, chronic sinus mucosa swelling, and foreign body reaction) and non-immune events (infection, fragmentation, and ejection). It is wise to use calcium phosphate-based material only in selected cases with small defects, and long-term follow-up is needed to observe their consequences.