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  Contents > Previous page > Article detail print Order
o Issue N# 2 - 2015 o

HEAD AND NECK CARCINOLOGY

Value of the preservation of an osseous mandibular rim with a fibula free flap reconstruction


Authors : Cortese S, Phulpin B, Mastronicola R, Gangloff P, Guillet J, Roch M, Julien L, Verhaeghe JL, Dolivet G. (Vandœuvre les Nancy)

Ref. : Rev Laryngol Otol Rhinol. 2015;136,2:61-66.

Article published in english
Downloadable PDF document english



Summary : Background: Reconstruction of the mandible with micro­vascularized fibula transplants is actually a well-established procedure, yet the major component is the limited diameter of the diaphysis that can induce oral rehabilitation’s failure, especially in dentate patients. In this paper, we report our surgi­cal procedure allowing preservation of the mandibular height. The primary objective was to assess aesthetic and func­tional improvements of preservation of an osseous mandibular rim with a fibula free flap reconstruction. Patients and methods: Five patients (all males, mean age of 60 years) were treated with this method. Aetiologies were tumour in 3 cases, and osteo­radionecrosis in the two others cases. We described all step of our surgical procedure and the functional, aesthetic and carcinologic results were evaluated. The follow up varies from 6 to 30 months. Results: One patient died at 12 days from unre­la­ted affection. For the other patients, both the aesthetics and functional outcomes were better than in case of mandibular interruption surgery. In fact, the mandibular contour of the mandibule was preserved and the height of mandible was restored. One patient is in progress of dental rehabilitation with osseous implants. Carcinologically, no local recurrence was observed. Conclusion: This technique is reliable and enables to optimize oral rehabilitation with endosteal implants. Nevertheless, we consider that the 3D scanner is essential before the intervention to evaluate the osseous reach. Moreover, if necessarily the procedure can be modified intraoperatively.

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