Single-Double-Single Barrel (1-2-1) Fibula Free Flap Design for Functional and Aesthetic Brown Class III Mandibular...

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Brown Class III mandibular defects present significant reconstructive challenges due to long-span defects affecting both mandibular bodies and the chin.
• Traditional fibula flap techniques may face limitations in achieving adequate mandible height and pedicle length for these complex cases.

Purpose of the Study:

• To introduce and evaluate a novel hybrid single-double-single barrel (1-2-1) fibula free flap design for reconstructing Brown Class III mandibular defects.
• To optimize functional and esthetic outcomes, including mandible height, pedicle length, and dental prosthesis support.

Main Methods:

• Utilized a hybrid fibula flap design combining single and double barrel segments tailored to specific mandibular regions (chin and body).
• Employed computer-assisted surgery for precise planning and execution of the reconstructive procedure.
• Assessed flap survival, bony healing, dental implant osseointegration, facial aesthetics, and occlusal rehabilitation post-surgery.

Main Results:

• Demonstrated favorable outcomes in terms of flap survival and bony union.
• Achieved successful dental implant osseointegration, enabling occlusal rehabilitation.
• Reported significant improvements in facial aesthetics and chin/lower lip projection.

Conclusions:

• The novel 1-2-1 hybrid fibula flap design effectively addresses the complexities of Brown Class III mandibular defects.
• This technique offers an improved solution for mandible reconstruction, balancing functional restoration with esthetic enhancement.
• The approach highlights the potential of innovative flap designs and computer-assisted surgery in complex reconstructive scenarios.