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Long-Term Outcomes after Pediatric Mandibular Reconstruction Using Vascularized Free Fibula Flap.

Shuo Liu1, Wen-Bo Zhang1, Yang Wang1

  • 1From the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology; National Center of Stomatology; National Clinical Research Center for Oral Diseases; and National Engineering Laboratory for Digital and Material Technology of Stomatology.

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Summary

Vascularized free fibula flaps provide safe and reliable mandibular reconstruction in pediatric patients, showing positive growth and good functional outcomes. This technique ensures facial symmetry and patient satisfaction long-term.

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Area of Science:

  • Oral and Maxillofacial Surgery
  • Pediatric Plastic Surgery
  • Regenerative Medicine

Background:

  • Mandibular defects in pediatric patients present unique challenges for reconstruction.
  • Vascularized free fibula flap (VFFF) is a common option for mandibular reconstruction.
  • Long-term outcomes in pediatric VFFF for mandibular reconstruction require further evaluation.

Purpose of the Study:

  • To assess the long-term outcomes of VFFF for mandibular reconstruction in pediatric patients.
  • To evaluate growth, function, and aesthetic results following VFFF.
  • To determine the safety and reliability of VFFF in this population.

Main Methods:

  • Retrospective review of pediatric patients undergoing VFFF for mandibular reconstruction (1999-2019).
  • Analysis of 3D CT data for grafted fibula and mandible dimensions.
  • Assessment of lower limb function (Enneking scale) and facial symmetry.

Main Results:

  • All 14 VFFF procedures were successful with no flap loss.
  • Significant growth in grafted fibula length and residual mandible length observed (P < 0.05).
  • Stable grafted fibula height (P > 0.05), symmetric mandible profile post-18 years (P > 0.05), and good limb function.

Conclusions:

  • Vascularized free fibula flap is a safe and effective method for pediatric mandibular reconstruction.
  • VFFF promotes mandibular growth and provides satisfactory long-term aesthetic and functional results.
  • This technique offers a reliable solution for improving facial symmetry and patient quality of life.