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.