Intraoperative planning and inset principles of fibula osteoseptocutaneous flap in compound or composite oromandibular defect reconstruction

Objectives: The use of free fibular osteocutaneous
flap was evaluated in the reconstruction of compound
and composite mandibular defects.
Patients and Methods: The study included 30 patients
(27 males, 3 females, mean age 52.6 years; range 42
to 66 years) who received free osteoseptocutaneous
fibular flap for the reconstruction of compound or composite
oromandibular defects following surgical tumor
ablation. Five patients with extensive skin defects
accompanying lateral mandible and oral defects also
received free anterolateral thigh perforator flap. Other
patients were treated with conventional fibular osteocutaneous
flap or its chimeric form. The mean follow-up
period was 19.4 months (range 8 to 38 months).
Results: With the applied technique, a successful
functional and aesthetic restoration was achieved without
total flap failure and with minimal donor site morbidity.
Infection and fascial abscess encountered in
one patient were treated with debridement and antibiotic
therapy. In one patient who developed osteonecrosis
in the neomandibula, the plate was removed and
debridement was performed in the 13th month.
Conclusion: By appropriate flap planning and
placement, reconstruction of large oromandibular
tumors with osteocutaneous fibular flaps provides
successful functional and aesthetic restoration.

Birleþik ya da kompozit oromandibüler defektlerin fibula osteoseptokutanöz fleple rekonstrüksiyonunda intraoperatif planlama ve flep yerleþtirme prensipleri

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