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Occipitoparietal bone flap for mandibular reconstruction

P L Dogliotti1, R D Bennun

  • 1Plastic Pediatric Unit, Hospital Nacional de Pediatria J.P. Garraham, Buenos Aires, Argentina.

The Journal of Craniofacial Surgery
|May 1, 1995
PubMed
Summary
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Vascularized occipitoparietal bone flaps offer effective mandibular reconstruction, providing solid union and functional recovery. This technique, utilizing occipital vessels, shows promise for pediatric cases involving tumor resection or hemifacial microsomia.

Area of Science:

  • Plastic Surgery
  • Oral and Maxillofacial Surgery
  • Pediatric Surgery

Background:

  • Mandibular reconstruction presents significant challenges.
  • Vascularized bone flaps are superior to bone grafts for mandibular reconstruction, ensuring solid union and faster functional recovery.

Purpose of the Study:

  • To evaluate the efficacy of a vascularized occipitoparietal bone flap technique for pediatric mandibular reconstruction.
  • To assess the feasibility and outcomes of using occipital vessels for flap pedicles.

Main Methods:

  • A full-thickness occipitoparietal bone flap, pedicled on occipital vessels (external carotid artery and jugular vein), was utilized.
  • The flap was dissected with a long pedicle, allowing for reconstruction in distant sites.
  • The technique was applied to four pediatric patients (ages 8-14) for mandibular reconstruction.

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Main Results:

  • The study included three cases of benign tumor resection (fibromyxoma, aneurysmal bone cyst) and one case of hemifacial microsomia.
  • All four patients underwent successful mandibular reconstruction using the described technique.
  • No complications were reported in any of the cases.

Conclusions:

  • The vascularized occipitoparietal bone flap technique is a viable and effective option for pediatric mandibular reconstruction.
  • The use of occipital vessels provides a long and reliable pedicle for flap transfer.
  • Further studies with a larger patient cohort are warranted to solidify these findings.