Extended and unusual indications in jaw reconstruction with the fibula flap: An overview based on our 30-year experience. (February 2021)

• Record Type: Journal Article
• Authors: De Santis, Giorgio; Pinelli, Massimo; Starnoni, Marta
• Is Part Of: Annals of medicine and surgery. Volume 62(2021)
• Page Start: 37
• Page End: 42
• Publication Date: 2021-02
• Subjects: Fibula flap -- Jaw reconstruction -- Maxillary atrophy -- Mandible reconstruction -- Head and neck reconstruction -- Orbital reconstruction -- Palate cleft -- Piezosurgery -- CAD/CAM -- Harmonic scalpel shears -- J-plasm; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2020.12.049
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Since the introduction of fibula flap as a reconstructive technique, an evolution of indications has been observed. Our first report of a traumatic mandibular reconstruction using fibula flap was in 1992. The vast majority of indications for surgery, are: malignant tumors, benign neoplasms, osteoradionecrosis and traumas. Nevertheless, extended indications have been described such as the treatment of dentoalveolar defect without bone discontinuity or reconstruction of maxilla defect up to type III (A and B), according to Cordeiro's classification. Unusual indications include cleft palate malformations with bone discontinuity less than 6 cm. Moreover, a particular attention should be focus on fibula flap harvest with more innovative technologies than traditional use of monopolar or bipolar and their advantages in pre and postoperative management. Highlights: The widely used indications for mandibular or maxillary reconstruction are malignant tumors, benign neoplasm, osteoradionecrosis and traumas. Extended indications are represented by other conditions such as dentoalveolar defect without bone discontinuity. Fibula flap can be used for the near-anatomic reconstruction of the orbit and for the obliteration of dead space. Fibula flap can be performed to reconstruct bone discontinuity less than 6 cm.