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Updated: Feb 22, 2026
06:32
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
731
Synchronous Reconstruction of a Total Mandibulectomy Defect With a Single Fibula Osteocutaneous Free Flap
Ramzey Tursun1, J Marshall Green2, Daniel Winokur3
1Assistant Professor of Clinical Surgery and Director, Head and Neck Oncologic and Microvascular Reconstructive Surgery, Division of Oral and Maxillofacial Surgery, University of Miami-Miller School of Medicine/Jackson Health System, Miami, FL.
Summary
Osteoradionecrosis (ORN) is a severe complication of head and neck cancer radiation. This report details a unique total mandibulectomy and reconstruction using a fibula flap, followed by dental implants.
Area of Science:
- Oncology
- Oral and Maxillofacial Surgery
- Plastic Surgery
Background:
- Osteoradionecrosis (ORN) is a significant late complication following radiation therapy for head and neck cancers.
- Radiation treatment, while life-extending, can cause acute and chronic tissue toxicity.
- Severe ORN, particularly bilateral cases, necessitates total mandibulectomy, posing complex reconstructive challenges.
Observation:
- This report presents a unique case of severe bilateral osteoradionecrosis requiring total mandibulectomy.
- The patient underwent synchronous reconstruction utilizing a single vascularized fibula osteocutaneous flap.
Findings:
- Successful total mandibulectomy was performed.
- A single vascularized fibula osteocutaneous flap enabled immediate, synchronous reconstruction.
- Subsequent dental implant reconstruction and prosthetic rehabilitation were achieved.
Implications:
- This case highlights the efficacy of free tissue transfer, specifically the vascularized fibula flap, in managing extensive ORN.
- Microvascular surgical advancements offer viable solutions for complex reconstructive challenges in ORN patients.
- Comprehensive rehabilitation, including dental implants, can restore function and aesthetics after major oncologic surgery.
