Mandibular reconstruction after hemimandibulectomy

Area of Science:

• Oral and Maxillofacial Surgery
• Oncology
• Regenerative Medicine

Background:

• Ameloblastoma is a benign odontogenic tumor originating from the mandible.
• Early diagnosis is often missed, necessitating extensive surgical intervention.
• Treatment may require significant mandible resection and reconstruction.

Observation:

• A case of ameloblastoma in a patient requiring hemimandibulectomy is presented.
• The patient underwent reconstruction using a free vascularized fibular flap, costochondral rib graft for temporomandibular joint restoration, and an iliac bone graft for vertical height enhancement.
• A 6-year follow-up period was utilized to assess the long-term outcomes.

Findings:

• The reconstruction successfully restored mandibular form and function.
• The combination of free vascularized fibular flap, costochondral graft, and iliac bone graft proved effective for complex mandible reconstruction.
• No significant complications or tumor recurrence were noted during the 6-year follow-up.

Implications:

• This case highlights the efficacy of multi-component reconstructive strategies for ameloblastoma treatment.
• The findings support the use of free vascularized fibular flaps and bone grafting for restoring mandibular integrity and temporomandibular joint function.
• Successful long-term outcomes suggest that such complex reconstructions are a viable option for managing extensive mandible tumors.