Long-term results of partial double-barrel vascularized fibula graft in symphysis for extensive mandibular reconstruction

J Oral Maxillofac Surg. 2012 Apr;70(4):983-91. doi: 10.1016/j.joms.2011.02.125. Epub 2011 Jul 20.

Abstract

Purpose: This study aimed to retrospectively review patients who underwent reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis.

Materials and methods: Ten patients who underwent reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis (n = 6) and partial double-barrel vascularized fibula graft in the symphysis combined with condylar prosthesis (n = 4) were reviewed. Five patients accepted secondary implantation postoperatively. Measurements of chin labial angle on lateral cephalograms and bone height on panoramic radiographs were performed at 2 years postoperatively in 8 patients. Measurements of chin labial angle were compared with preoperative values. Bone height measurements were compared with measurements obtained preoperatively and at 1 month postoperatively. Eight patients with follow-up greater than 2 years were also asked to rate their satisfaction with their facial appearance.

Results: The mean follow-up period was 43.0 months. Bony union and wound healing were observed in all patients during the follow-up period. There was no significant difference in the mean chin labial angle between preoperative measurements and measurements at 2 years postoperatively (P = .128). There was no significant difference in mean bone height between 1 month postoperatively and 2 years postoperatively (P > .05). Eight patients reported that their facial appearance was excellent or good at 2 years postoperatively.

Conclusions: Reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis could not only achieve good facial appearance and function but also maintain soft and hard tissue stability in the long term.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Bone Transplantation / methods*
  • Cephalometry
  • Chin / pathology
  • Esthetics
  • Female
  • Fibula / surgery
  • Follow-Up Studies
  • Humans
  • Joint Prosthesis
  • Longitudinal Studies
  • Male
  • Mandible / pathology
  • Mandibular Condyle / surgery
  • Mandibular Diseases / surgery*
  • Mandibular Neoplasms / surgery
  • Middle Aged
  • Osteotomy / methods
  • Patient Care Planning
  • Patient Satisfaction
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications
  • Retrospective Studies
  • Skin Transplantation / methods*
  • Tissue and Organ Harvesting / methods
  • Young Adult