Indications and outcomes for mandibular reconstruction using sequential bilateral fibula flaps.

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Oncology

Background:

• Patients with recurrent or second intraoral tumors often require mandibular reconstruction.
• Bilateral fibula flaps are utilized for both primary and secondary reconstructions in these cases.

Purpose of the Study:

• To describe the indications for and outcomes of secondary mandibular reconstruction using fibula flaps.
• To evaluate the safety and functional results of repeat fibula flap use.

Main Methods:

• Retrospective analysis of a prospectively collected database.
• Review of patient charts for demographics, operative details, and functional outcomes.

Main Results:

• Ten patients received a second fibula flap for recurrent oral tumors.
• Secondary reconstructions had larger soft-tissue defects, often involving the mandibular arch.
• Complication and flap failure rates were low, but functional outcomes showed increased need for enteral nutrition.

Conclusions:

• Second fibula flaps are indicated for central defects requiring rigid support to prevent the Andy Gump deformity.
• Soft-tissue flaps may be preferable for large lateral defects after secondary resection.
• While safe, repeat fibula flaps lead to significant declines in oropharyngeal function, necessitating careful consideration of surgical goals and quality of life.