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Costal Grafting in Mandibular Reconstruction
Jean-Thomas Bachelet1, Jerôme Bourlet1, Joseph Château1
1Service de chirurgie maxillo-faciale, Service de chirurgie plastique reconstructrice et esthétique, Hôpital de la Croix-Rousse-CHU de Lyon, Lyon, France; Service de chirurgie maxillo-faciale, Centre Hospitalier Lyon Sud-CHU de Lyon, Pierre-Bénite, France; and Service de Radiologie pédiatrique, Hôpital Femme Mère Enfant, Bron, France.
Costal grafting offers a reliable and efficient alternative for mandibular reconstruction, achieving a high graft survival rate of 92.6%. This technique provides successful dental rehabilitation in 70% of cases, presenting a viable option when free fibular flaps are contraindicated.
Area of Science:
- Craniomaxillofacial Surgery
- Oral and Maxillofacial Surgery
- Reconstructive Surgery
Background:
- Mandibular bone defect reconstruction is a frequent procedure in craniomaxillofacial surgery.
- Free fibular flap is the established gold standard for mandibular reconstruction.
- Nonvascular bone grafting, specifically costal grafting, presents a reliable alternative with potentially lower morbidity.
Purpose of the Study:
- To evaluate the efficacy and outcomes of costal grafting for mandibular reconstruction.
- To compare costal grafting with the standard free fibular flap technique in specific indications.
- To assess graft survival and the potential for dental rehabilitation following costal grafting.
Main Methods:
- A retrospective review of 54 patients undergoing mandibular reconstruction using costal grafting over a 9-year period.
- Detailed description of the surgical technique employed for costal grafting.
- Analysis focused primarily on graft survival rates.
Main Results:
- Successful engraftment was achieved in 92.6% of the 54 patients who underwent mandibular reconstruction with costal grafting.
- The study included defects in the symphysis (5), corpus (46), and ramus (20) of the mandible.
- Dental rehabilitation using dental implants was successfully accomplished in 70% of the cases.
Conclusions:
- Costal grafting provides a reliable and efficient method for mandibular reconstruction, yielding good results.
- This technique is a valuable alternative to free fibular flaps, particularly when the latter is contraindicated.
- Successful dental rehabilitation is achievable with costal grafting, enhancing functional outcomes.
