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Mandibular reconstruction in children using the vascularized fibula
T G Iconomou1, R M Zuker, J H Phillips
1Department of Surgery, The Hospital for Sick Children, Toronto, Ontario, Canada.
Journal of Reconstructive Microsurgery
|March 24, 1999
Summary
Vascularized fibula transfers effectively reconstruct the mandible in children, achieving good occlusion and function. However, soft-tissue contouring remains a challenge in these pediatric reconstructions.
Area of Science:
- Plastic Surgery
- Pediatric Surgery
- Oral and Maxillofacial Surgery
Background:
- Mandibular defects in children often require complex reconstruction.
- Vascularized fibula free flaps are a viable option for restoring mandibular continuity and function.
Observation:
- This study reviewed 10 pediatric patients (ages 5-17) undergoing mandibular reconstruction using vascularized fibula transfers.
- Procedures included mandible reconstruction, temporomandibular joint (TMJ) restoration, and soft-tissue defect management with vascularized muscle.
- Follow-up ranged from 3 to 30 months, with assessments including dental occlusion, facial symmetry, and mouth opening.
Findings:
- All fibula free flaps survived, confirmed by bone scanning.
- Excellent Class 1 occlusion was achieved in all patients.
- While flap stability and function were normal, soft-tissue contour presented aesthetic challenges.
Implications:
- Vascularized fibula transfer is a reliable technique for pediatric mandibular reconstruction, offering good functional outcomes.
- Addressing soft-tissue contour deficits requires further refinement for optimal aesthetic results.
- This reconstructive approach demonstrates low complication rates at both donor and recipient sites.