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Updated: May 23, 2026
A Postoperative Evaluation Guideline for Computer-Assisted Reconstruction of the Mandible
Published on: January 28, 2020
Aesthetic and anatomic subunit reconstruction of composite mandibular gunshot wound
Andreas Gravvanis1, Thomais Iconomou, Dimosthenis Tsoutsos
1Department of Plastic Surgery, Microsurgery and Burn Center J Ioannovich, General State Hospital of Athens G Gennimatas, Athens, Greece. gravvani@yahoo.com
Background:
Gunshot facial traumas involving the mandible and surrounding soft tissues are represented by the potential for loss of relationships between the functional and the aesthetic subunits of the head.
Methods:
A patient presented with an 8-cm composite mandibular defect, resulting from a self-inflicted gunshot injury. Taking into account the anatomic/aesthetic subunits involved, a fibular osseoseptocutaneous flap was transferred to reconstruct the left lateral mandibular segment and the floor of the mouth, whereas a preexpanded temporal scalp flap was transferred to restore the hair-bearing skin of the left buccomandibular subunit. A review of the literature is also presented.
Results:
A satisfactory functional and aesthetic outcome was achieved. Although current literature supports the value of aesthetic subunit face reconstruction and the use of double flaps for the reconstruction of through-and-through oromandibular defects, there is no previous report of the combined use of temporal scalp flap and fibular osseocutaneous flap.
Conclusions:
The combined use of hair-bearing skin and osseocutaneous flap may achieve optimal results in through-and-through oromandibular defects.
