ONE-STAGE (PRIMARY) RECONSTRUCTIONS OF RESECTION MANDIBULAR DEFECTS BY MEANS OF AUTOGENE VASCULARISED ILIAC AND...

Area of Science:

• Oral and Maxillofacial Surgery
• Reconstructive Surgery
• Oncology

Background:

• Mandibular resections are frequently necessitated by tumor ablations.
• One-stage reconstruction using microvascularized transplants with intact circulation is a contemporary surgical approach.
• Iliac crest and fibula are common sources for mandibular reconstruction grafts.

Purpose of the Study:

• To present experience with one-stage mandibular defect reconstruction using autogene vascularized iliac and fibular transplants simultaneously with tumor resection.
• To evaluate the efficacy of these reconstructive techniques.

Main Methods:

• Surgical reconstruction of mandibular defects in 8 patients (aged 24-61) with mandibular tumors (5 benign, 2 malignant).
• Utilized one-stage autogene vascularized iliac bone transplants in 3 patients and fibular autotransplants in 5 patients.
• Employed extraoral approach in 7 cases and intraoral approach in 1 case.

Main Results:

• Postoperative follow-up ranged from 1 to 3 years.
• Satisfactory speech and feeding were achieved due to restored lip and tongue support.
• Observed anatomical remodeling, improved conditions for dental implants, and satisfactory to fully restored facial aesthetics.

Conclusions:

• Vascularized autogene iliac and fibular bone transplants are highly suitable for reconstructing significant mandibular and maxillofacial defects.
• Graft survival is independent of the recipient site, secured by vascular anastomoses.
• High success rates are achievable with sound surgical techniques.