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ITALIAN JOURNAL OF MAXILLOFACIAL SURGERY
Rivista di Chirurgia Maxillo-Facciale
Official Journal of the Italian Society of Maxillofacial Surgery
Italian Journal of Maxillofacial Surgery 2013 August;24(2):57-62
Computer-assisted free fibula flap technique for mandibular reconstruction: preliminary experience
Zavattero E., Garzino-Demo P., Fasolis M., Ramieri G. A.
Department of Surgical Sciences, Città della Salute e della Scienza di Torino, University of Turin, Turin, Italy
Aim: This work documents our experience using computer assisted free fibula flap for reconstruction of large mandibular defects for benign tumors.
Methods: Between December 2012 and April 2013, a total of 3 free osteocutaneous computer assisted fibula flaps have been used in an equal number of patients for reconstruction of the mandible, at the Division of Maxillofacial surgery, Città della Scienza e della Salute Hospital, University of Turin. Inclusion criteria were large mandibular defect due to benign tumors. The computer assisted fibula flap was chosen when two or more osteotomies were requested. Intraoperative complication, mean ischemia time, operative time and morphological outcomes were analyzed in all cases.
Results: All three flaps were harvested and transplantated successfully. For the free flaps examinated in this work, no intraoperative complications were noted. The bone continuity was good in all cases and the contour respected at all the virtual reconstruction planned. The immediate and long-term morphologic results were satisfactory.
Conclusion: Microsurgical mandible reconstruction using a computer-assisted fibula flap technique is the best available method to manage complex defects.