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Quantifying Free Fibula Flap Growth After Pediatric Mandibular Reconstruction
Angela S Volk1, Sylvia S H Riad, Katarzyna E Kania
1Division of Plastic Surgery, Texas Children's Hospital, Baylor College of Medicine, Houston, TX.
The Journal of Craniofacial Surgery
|July 1, 2020
Summary
Pediatric mandibular reconstruction with a free fibula flap (FFF) shows promising growth. Advanced 3D analysis confirms mandibular growth post-reconstruction, particularly at the preserved condyle, ensuring functional and cosmetic outcomes.
Area of Science:
- Craniofacial surgery
- Pediatric reconstructive surgery
- Biomedical engineering
Background:
- Free fibula flap (FFF) is a standard for adult mandibular reconstruction but its use in pediatric patients is debated due to growth concerns.
- Existing literature presents conflicting data on the growth potential of FFF in pediatric mandibular reconstruction.
- This study quantifies mandibular growth in a pediatric patient after hemi-mandibular reconstruction using FFF and 3D software.
Observation:
- A 2-year-old patient underwent hemi-mandibular reconstruction with FFF, preserving the condyle.
- Preoperative and serial postoperative CT scans (ages 2.1, 2.5, and 5.2) were analyzed using 3D software.
- Growth and morphological changes in the reconstructed mandible were meticulously evaluated.
Findings:
- Significant mandibular growth was observed post-reconstruction in both postoperative assessments.
- The greatest growth occurred in the ramus height.
- A novel parts comparison analysis indicated that the preserved condyle exhibited the most substantial growth potential.
Implications:
- The study demonstrates that FFF reconstruction in pediatric patients allows for continued mandibular growth.
- Preserving the condyle appears crucial for maximizing growth potential in the reconstructed mandible.
- These findings suggest FFF is a viable option for pediatric mandibular reconstruction, supporting functional and aesthetic rehabilitation.
