BACKGROUND: The free fibula osteoseptocutaneous flap remains the first choice for segmental mandible and contiguous soft-tissue defect reconstructions in most situations. METHODS: Several important principles are described that should be respected during skin paddle design: fibula contouring, insetting, and fixation, and dental implant osseointegration. Recent advancements that address difficulties in height contouring, particularly at the anterior segment, are highlighted. RESULTS: The presented methods can help provide an optimal mandibular reconstruction that restores mechanical functions, facial aesthetics, and complete dental competence. CONCLUSION: Efficient interdisciplinary communication and teamwork are necessary throughout the longitudinal care of the patient if optimal results are to be achieved.
BACKGROUND: The free fibula osteoseptocutaneous flap remains the first choice for segmental mandible and contiguous soft-tissue defect reconstructions in most situations. METHODS: Several important principles are described that should be respected during skin paddle design: fibula contouring, insetting, and fixation, and dental implant osseointegration. Recent advancements that address difficulties in height contouring, particularly at the anterior segment, are highlighted. RESULTS: The presented methods can help provide an optimal mandibular reconstruction that restores mechanical functions, facial aesthetics, and complete dental competence. CONCLUSION: Efficient interdisciplinary communication and teamwork are necessary throughout the longitudinal care of the patient if optimal results are to be achieved.
Authors: Abel P David; Chase Heaton; Andrea Park; Rahul Seth; P Daniel Knott; Jeffrey D Markey Journal: JAMA Otolaryngol Head Neck Surg Date: 2020-06-01 Impact factor: 6.223