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Symmetrical Midfacial Growth After Pediatric Mandibular Reconstruction With Free Fibula Flap
Shuo Liu1, Wen-Bo Zhang2, Yao Yu2
1Attending Doctor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing, China.
Summary
Pediatric mandibular reconstruction using free fibula flaps did not cause severe midface deformities. Proper reconstruction and occlusion promote midfacial growth and symmetry in young patients.
Area of Science:
- Craniofacial surgery
- Pediatric reconstructive surgery
- 3D cephalometry
Background:
- Free fibula flap is a common method for mandibular reconstruction, even in pediatric cases.
- The impact of free fibula flap mandibular reconstruction on pediatric midfacial symmetry is not well understood.
- Craniomaxillofacial growth is an interdependent process, necessitating evaluation of midfacial development post-reconstruction.
Purpose of the Study:
- To evaluate midfacial symmetry in pediatric patients following mandibular reconstruction with a free fibula flap.
- To assess the long-term effects of this reconstructive technique on facial growth and development.
Main Methods:
- Retrospective cohort study of pediatric patients (≤14 years) undergoing free fibula flap mandibular reconstruction.
- Postoperative computed tomography (CT) scans analyzed using 3D cephalometry at multiple time points.
- Midfacial symmetry assessed in horizontal, vertical, and anteroposterior dimensions; patient satisfaction evaluated via visual analog scale.
Main Results:
- Thirteen pediatric patients (9 males, 4 females; mean age 12.23 years) were included.
- From 1 year post-surgery, the affected side showed increased distance from the upper first molar to the horizontal plane (0.7-1.6 mm) and decreased distance from the pterygomaxillary fissure to the coronal plane (0.6-1.2 mm).
- No significant differences were found in other measurements; all patients reported satisfaction with postoperative facial symmetry.
Conclusions:
- Free fibula flap reconstruction for pediatric mandibular defects does not lead to severe midface deformities.
- Effective mandibular reconstruction and achieving proper occlusion in pediatric patients can support midfacial growth and symmetry.
- This technique is a viable option for pediatric mandibular reconstruction, promoting satisfactory aesthetic and functional outcomes.
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