Two cases of reconstruction of mandibular defects with free vascularised osteocutaneous fibula flap.

概要

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Two free vascularized osteocutaneous fibula flaps were used for reconstruction of mandibular defects in patients with squamous cell carcinoma of the lower gingiva.<BR>One had been carried out as a secondary reconstruction nearly three years after sectional mandibulectomy including a mandibular angle. In this case complete necrosis of the skin paddle and infection surrounding the intraosseous wires occurred after the operation. The defects of the soft tissue were closed spontaneously after several weeks and infection was managed by removal of the wires. As a result, a flat contour on the reconstructed mandibular angle was obtained. It is thought that this might be because of the straight form of the fibula. As we could not improve the scar contraction caused by the first surgery, jaw movements are still limited.<BR>The second patient had undergone an immediat e reconstruction after sectional mandibulectomy of the premolar and molar region. Hematoma and infection after operation was managed by drainage. The latest result showed a satisfactory face contour and adequate jaw movements. The morbidity of the donor site was light in both patients.<BR>We concluded that a free vascularized osteocutaneous fibula flap is useful for reconstruction of the mandibular defects particularly in the straight part of the body, associated with limited soft tissue loss. Furthermore, immediate reconstruction is recommended.
社団法人日本口腔外科学会の論文