Mandibular reconstruction in children

Facial deformities due to loss of mandibular segments in children lead to severe functional and psychological disturbances. Such deformities should be corrected taking into account both contour and function. In addition, they should be planned for long-term growth and performed in the fewest possible surgical stages. This article presents the experience in seven cases of mandibular reconstruction in children after surgical ablation for benign conditions. We performed a scapular flap in one case and fibular flaps in six. The mean age of the patients was 9.1 years. Follow-up ranged from 1.5 to 5 years. All flaps survived. No osseous remodeling was needed in any case. All patients showed symmetrical facial and mandibular growth, as well as adequate masticatory function. Excision of the tumor and reconstruction should be carried out in the same surgical procedure whenever possible. The fibula was used in most cases because of its easy dissection, the ample amount of bone it provides, and the potential to redirect it. The author favors mandibular reconstruction in children with a free flap, as this approach offers adequate form and function in the long term.