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Midface reconstruction with the fibula free flap
Neal D Futran1, Jeffrey Trad Wadsworth, Douglas Villaret
1University of Washington School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Box 356515, Seattle, WA 98195-6515. nfutran@u.washington.edu
Archives of Otolaryngology--Head & Neck Surgery
|February 15, 2002
Summary
The fibula osteocutaneous free flap is a reliable option for midface reconstruction, particularly for lower maxillary defects. While effective for bony reconstruction, its utility is limited for orbitozygomatic support, requiring individualized technique selection.
Area of Science:
- Plastic Surgery
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
Background:
- Midface defects often require complex reconstruction.
- Conventional prostheses may be insufficient for certain patients.
- Vascularized bony reconstruction offers an alternative for structural restoration.
Purpose of the Study:
- To evaluate the use, indications, and outcomes of fibula osteocutaneous free flaps in midface reconstruction.
- To assess the success rates and complications associated with this technique.
- To determine functional and aesthetic results following reconstruction.
Main Methods:
- Retrospective case series review of 27 patients undergoing midface reconstruction.
- Patients had tumor resection and lacked support for conventional prostheses.
- Fibular osteocutaneous free flaps were used for reconstruction.
Main Results:
- High flap survival rate (26/27).
- Successful functional outcomes including regular or soft diet for most patients.
- Good to excellent cosmetic results reported in 22 out of 27 patients.
Conclusions:
- Fibula osteocutaneous free flap is highly reliable for lower maxillary bony reconstruction.
- Its utility is limited when orbitozygomatic support is the primary goal.
- Individualized patient assessment is crucial for selecting midface reconstruction techniques.