medigraphic.com
ISSN 1870-199X (Print)
Órgano oficial de la Facultad de Odontología, UNAM

2008, Number 2

<< Back Next >>

Rev Odont Mex 2008; 12 (2)

Mandibular anterior zone reconstruction with fibular microvascularized graft in double barrel. Case report

González QA, De La Piedra GJ, Santamaría LE, Castaño MM

Language: Spanish
References: 40
Page: 88-93
PDF size: 233.67 Kb.


ABSTRACT

Mandibular reconstruction has two main purposes: to reestablish function and aesthetics. To achieve this purposes, autogenous non vascularized osseous grafts and alloplastic implants that present some complications such as reabsorption and exposition are used. Osseous vascularized grafts are mainly used for treatment in patients with inappropriate conditions of the graft bed. The fibular microvascularized graft in double barrel offers an adequate bone height, re-establishing the continuity of the basal border and the mandibular alveolar process. Objective: To demonstrate the use of the fibular microvascularized graft in double barrel for mandibular reconstruction of the anterior segment. Materials and methods: The surgical procedure was carried out in a 43 year old male patient with fire guns wounds antecedents, the first time treated with a conventional surgical intervention without improvement in function and aesthetic results; that is why it was decided to use the fibular microvasculared graft in double barrel. Conclusions: Fibular quality and rich blood supply allow the graft located in the anterior mandibular area to present less morbidity. Graft located in double barrel is an alternative that offers stability, height, and bone thickness to achieve a functional mandibular reconstruction that provides an adequate support to place osteointegrate implants and its consecutive prosthetic rehabilitation.


REFERENCES

  1. Lawson W, Biller HF. Mandibular reconstruction: bone graft techniques. Otolaryngol Head Neck Surg 1982; 90: 589.

  2. Hidalgo DA. Fabula free flap: A new method of mandible reconstruction. Plast Reconstr Surg 1989; 84: 71.

  3. Siemmsen SO, Kirkby B, O’Connor TP. Immediate reconstruction at a resected segment of the lower jaw using a compound flap of clavicle and sternomastoid muscle. Plast Reconstr Surg 1978; 61: 724.

  4. Panje W, Cutting C. Trapezius osteomyocutaneous island flap for reconstruction of the anterior floor of the mouth and the mandible. Head Neck Surg 1980; 3: 66.

  5. Radcliffe GJ, Mady S, Cheesman AD. The use of osteomyocutaneous flaps in mandibular reconstruction. J Laryngol Otol 1982; 96: 1043.

  6. Conlay J. Use of composite flaps containing bones for major repairs in the head and neck. Plast Reconstr Surg 1972; 7: 522.

  7. Cutting CB, McCarthy JG, Berenstein A. Blood supply of the upper craniofacial skeleton: The search for composite calvarial bone flaps. Plast Reconstr Surg 1984; 74: 603.

  8. Munoz FI, Juncosa AM, Carillo FO. Vascularized parietal bone flaps. A new dimension in mandibular reconstruction. J Cranio-Max-Fac Surg 1990; 18: 158.

  9. Green MF, Gibson JR, Bryson JF, Thomson E. A one-stage correction of mandibular defects using a split sternum pectoralis major osteomusculocutaneous transfer. Br J Plast Surg 1981; 34: 11.

  10. Serafilm D, Villareal-Rios A, Giorgiade NG. A rib-containing free flap to reconstruct mandibular defects. Br J Plast Surg 1977; 30: 263.

  11. Cuono CB, Ariyan S. Immediated reconstruction of a composite mandibular defect with a regional osteomusculocutaneous flap. Plast Reconstr Surg 1980; 65: 477.

  12. Torstein L, Olav A. The vascularized fibular flap for mandibular reconstruction. J Cranio-Max-Fac Surg 1991; 19: 113-118.

  13. McCullough DW, Fredrickson JM. Neovascularized rib grafts to reconstruct mandibular defects. Can J Otol 1973; 2: 96.

  14. Ostrup LT, Fredrickson JM. Distant transfer of a free living bone graft by microvascular anastomoses. Plast Reconstr Surg 1974; 54: 277.

  15. Taylor GI, Townsend P, Corlett R. Superiority of the deep circumflex iliac vessels as the supply for free groin flaps – experimental work. Plast Reconstr Surg 1979; 64: 595.

  16. Taylor GI, Townsend P, Corlett R. Superiority of the deep circumflex iliac vessels as the supply for free groin flaps – clinical work. Plast Reconstr Surg 1979; 64: 745.

  17. Taylor GI. Reconstruction of the mandible with free composite iliac bone grafts. Ann Plast Surg 1982; 9: 361.

  18. Taylor GI, Miller G, Ham F. The free vascularized bone graft: A clinical extension of microvascular techniques. Plast Reconstr Surg 1975; 55: 533.

  19. Hidalgo DA. Fibula free flap: A new method of mandible reconstruction. Plast Reconstr Surg 1989; 84: 71-79.

  20. Divaris M, Goudot P, Princ. G, Lalo J, Vaillant JM. Mandibular reconstruction by free bone flaps with micro-anastomosis. Our current indications. Ann Chir Plast Esthet 1992; 37: 297-308.

  21. Foster RD, Anthony JP, Sharma A, Pogrel MA. Vascularized bone flaps versus nonvascularized bone grafts for mandibular reconstruction: An outcome analysis of primary bony union and endosseous implant success. Head Neck 1999; 21: 66-71.

  22. Taylor GI. Reconstruction of the jaw with free composite iliac bone grafts. In: Buncke HJ, Furnas DW, eds: Symposium on Clinical Frontiers in Reconstructive Microsurgery, St. Louis: The CV Mosby Co. 1984: 24: 106-122.

  23. Lee JH, Kim MJ, Kim JW. Mandibular reconstruction with free vascularized fibular flap. J Craniomaxillofac Surg 1995; 23: 20-26.

  24. Bahr W, Stoll P, Wachter R. Use of the double barrel free vascularized fibula in mandibular reconstruction. J Oral Maxillofac Surg 1998; 56: 38-44.

  25. Serra JM, Vila R. Microcirugía reparadora. Barcelona, Salvat, 1985: 145.

  26. Gilbert A. Vascularized transfer of the fibula graft. Int J Microsurg 1979; 1: 100.

  27. Ho Lee J, Jin Kim M, Won Kim J. Mandibular reconstruction with free vascularized fibular flap. J Cranio-Maxillo-Facial Surg 1995; 23: 20-26.

  28. O’Brien B, Morrison WA. Reconstructive microsurgery. Edinburgh, Churchill Livingstone, 1987.

  29. Barth E. Histologische untersuchungen ubre Knochentransplantationen. Beitr Pathol Anat 1985; 17: 65.

  30. Bitter K, Schlesinger S, Westermann U. The iliac bone or osteocutaneous transplant pedicled to the deep circumflex iliac artery: II Clinical application. J Maxillofac Surg 1983; 11: 241.

  31. Riediger D. Restoration of masticatory function by microsurgically revascularized iliac crest bone grafts using endosseous implants. Plast Reconstr Surg 1988; 81: 861.

  32. Serra JM, Paloma V, Mesa F. The vascularized fibula graft in mandibular reconstruction. J Oral Maxillofac Surg 1991; 49: 244.

  33. O’Brian, Gumley GJ, Dooley BJ. Folded free vascularized fibula transfer. Plast Reconstr Surg 1988; 82: 311.

  34. Kurz LT, Garfio SR, Booth RE. Harvesting autogenous iliac bone graft. A review of complications and techniques. Spine 1989; 14: 1324.

  35. Lyberg T, Obstad OA. The vascularized fibular flap for mandibular reconstruction. J Craniomaxillofac Surg 1991; 19: 113.

  36. Wei FC, Seah CS, Tsai YC. Fibula osteo-septocutaneous flap for reconstruction of composite mandibular defects. Plast Reconstr Surg 1994; 93: 294.

  37. Colen SR, Shaw WW, Mc Carthy JG. Review of the morbidity of 300 free-flap donor sites. Plast Reconstr Surg 1986; 77: 948.

  38. Wells MD. Mandibular reconstruction using vascularized bone grafts. J Oral Maxillofac Surg 1996; 54: 883.

  39. Gilbert A. Vascularized transfer of the fabular shaft. Int J Microsurg 1979; 1: 199.

  40. Anthony J, Foster R. The free fibula bone graft for salvaging failed mandibular reconstructions. J Oral Maxillofac Surg 1997; 55: 1417-1421.




2020     |     www.medigraphic.com