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Rivista Italiana di Chirurgia Maxillo-Facciale 2002 August;13(2):101-9

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Fibula free flap in oro-facial reconstruction

Cortelazzi R. ¹, Chiarini L. ², Turco M. ¹, Urbani U. ¹, Nocini P. F. ³

¹ Unit of Maxillo-Facial Surgery University of Bari, Bari 2 Unit of Odontostomatology University of Modena and Reggio Emilia, Modena 3 Maxillo-Facial Surgery University of Verona, Verona

At ­present fib­u­la ­free ­flap ­has ­many indi­ca­tions in ­oro-­facial recon­struc­tions. Intro­duc­ing ­some chang­es to ­the ­basic tech­nique ­described by Hidal­go it is pos­sible to har­vest dif­fer­ent tis­sue com­po­nents, var­i­ous­ly com­bined in ­the com­pos­ite fib­u­la ­free ­flaps. In ­this ­review ­the ­authors ­define stan­dards to ­choose ­between ­these vari­a­tions. ­Some fac­tors ­depend on ­the gen­er­al con­di­tions of ­the ­patient, ­the ­local con­di­tions of ­the recip­i­ent ­bed ­and ­the stat­us of ­the sur­round­ing ­hard ­and ­soft tis­sues. Oth­er fac­tors ­are exam­ined in ­this ­paper: ­the ­size, ­the loca­tion ­and typol­o­gy of ­bony ­and ­soft tis­sue ­defect, sim­ple or com­plex, ­the recon­struc­tive ­goal ­and prog­no­sis. A care­ful eval­u­a­tion of ­the 3D rela­tion ­between ­the dif­fer­ent com­po­nents of ­the ­defect is nec­es­sary to ­obtain a ­good func­tion­al ­and aes­thet­ic out­come. A pre­sur­gi­cal assess­ment is man­da­to­ry ­for a cor­rect eval­u­a­tion of ­these fac­tors ­and a prop­er recon­struc­tive ­plan.