ORIGINAL ARTICLES   

Journal of Maxillofacial Trauma 2013 April;2(1):1-13

Copyright © 2013 EDIZIONI MINERVA MEDICA

language: English

Fibula free flaps for mandibular reconstruction: a 10-year experience including the introduction of virtual surgical planning

Honeybrook A. ¹, Sexton K. ¹, Patel A. ², Kelly K. ³, Foley B. ⁴, Press S. ⁴, Bruce Shack R. ³, Thayer W. ³

¹ Division of General Surgery Vanderbilt University Medical Center, Nashville, TN, USA; ² Division of Plastic Surgery Albany Medical College, New York, USA; ³ Department of Plastic Surgery Vanderbilt University Medical Center, Nashville, TN, USA; ⁴ Department of Oral and Maxillofacial Surgery Vanderbilt University Medical Center, Nashville, TN, USA

Aim: We aim to explore the utility of virtual surgical planning (VSP) to reduce operative times by presenting a 10-year experience with the use of a free fibula flap for mandible reconstruction.
Methods: Twenty-two patients were evaluated that underwent maxillofacial reconstruction with the use of a free fibula flap. Demographic, intraoperative, and postoperative data was collected for comparison.
Results: The cohort included 12 men and 10 women with a mean age of 49.05 years. The most common indication for surgery was trauma from gunshot wounds (9, 39%). Eighteen patients (82%) had undergone mandibular surgery prior to free fibula flap reconstruction. Nine (41%) patients had postoperative complications with four (18%) patients developing partial flap loss. There were no patients who developed total flap loss. Seven (32%) patients underwent virtual surgical planning. The mean surgery duration was less with the use of VSP (mean 680 minutes, SD 41) when compared to those patients who did not undergo VSP (mean 903 minutes, SD 250) (P=0.03). VSP use predicted reduced surgical duration in univariate tests (r=-0.46, P=0.032 [odds ratio 1.03; 95% confidence interval {CI} 1.01-1.06]) and in multivariate analysis (P=0.037).
Conclusion: Our results suggest the reliability of this reconstruction method and relatively low morbidity results. This study also confirms the utility of VSP as a method of pre-operative surgical planning to reduce operative times.