Title : Reconstruction of the mandible and maxilla with a microvascular fibular flap
Abstract:
Introduction: The anatomical defects left by the tumors that affect the face make us more sensitive to their destruction. The difficulties faced in facial reconstructions and rehabilitations are different for each case. Each surgical process is a challenge, especially when there is a great reconstruction to be carried out due to the anatomical defect created by the resection of cancer in the region of the head and neck, which motivates the development of new reconstruction techniques. Reconstructions with microvascularized fibula retail are a routine in our institution, so this makes us seek alternatives to give better comfort to patients covering functionality and aesthetic issues. The use of new techniques for reconstructing the middle third of the face using a microvascular fibular flap has answered our questions.
Objective: To show reconstructions with microvascularized fibula retail in large defects in mandible and new technique for the zygomatic–maxilla complex reconstruction and orbital floor, due to the difficulty in rotating the soft tissues, pedicle.
Method: 1- For patients whom require complementary therapy with radiotherapy, there is a security time to exercise or indicate radiation treatment. With the variables of more contact surface area between the segments, which facilitates bone neoformation and retail stability, thus decreasing the chance of losses of osseous segments or necrosis. 2- (New technique) After harvesting The fibula free flap in the standard fashion, differentiated osteotomies, modeling and arrangement of the fibular bone segments are performed in the receptor site of the middle third of the face.
Result: These variables in the reconstruction technique of the microvascularized fibular retail have raised a satisfactory result in aesthetics and function.
Conclusion: The new technique presented has the advantage in reconstruction of requiring only one flap, promoting the resolution of the technical difficulties of the middle third of the face.
