Surgical Management of Ameloblastoma in the Mandible: Segmental Mandibulectomy and Immediate Reconstruction With Free Fibula or Deep Circumflex Iliac Artery Flap (Evaluation of the Long-Term Esthetic and Functional Results)

Vayvada, Haluk; Mola, Fahri; Menderes, Adnan; Yilmaz, Mustafa

doi:10.1016/j.joms.2005.11.065

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 64, Issue 10 , Pages 1532-1539, October 2006

Surgical Management of Ameloblastoma in the Mandible: Segmental Mandibulectomy and Immediate Reconstruction With Free Fibula or Deep Circumflex Iliac Artery Flap (Evaluation of the Long-Term Esthetic and Functional Results)

Haluk Vayvada, MD
- Assistant Professor, Department of Plastic and Reconstructive Surgery, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
- Address correspondence and reprint requests to Dr Vayvada: Plastik ve Rekonstruktif Cerrahi Anabilim Dali, Dokuz Eylul Universitesi Tip Fakultesi, 35340 Inciralti Izmir, Turkey
Fahri Mola, MD
- Resident, Department of Plastic and Reconstructive Surgery, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
Adnan Menderes, MD
- Assistant Professor, Department of Plastic and Reconstructive Surgery, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.
Mustafa Yilmaz, MD
- Associate Professor, Department of Plastic and Reconstructive Surgery, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey.

Purpose

Ameloblastoma is responsible for 1% of all the oral and maxillomandibular cysts and tumors. It is odontogenic in origin and benign in nature but it has a high percentage of local recurrence rate and possible malignant development when treated inadequately. With the advancement of craniofacial surgical techniques, use of free flaps for mandibular reconstruction, and dental rehabilitation (such as osseointegration), the segmental mandibulectomy and immediate reconstruction with free flaps are beginning to be used more effectively for the treatment of the mandibular ameloblastoma. The aim of this article is to evaluate the clinical results of the patients with mandibular ameloblastoma who were treated with segmental mandibulectomy and immediate reconstruction with free flaps.

Patients and Methods

We present 11 patients who had segmental mandibulectomy and immediate reconstruction with free deep circumflex iliac artery or fibular flap for treatment of mandibular ameloblastoma. The average age of the patients was 25.4 years (range, 18–38 years). The patients were followed up for a mean of 29.3 months (range, 17–38 months). The functional and esthetic results were also evaluated by using a questionnaire in the long term. The questionnaire consisted of questions addressing oral continence, diet, social activities, speech, and facial appearance.

Results

All flaps survived totally. Recurrence was not detected during the follow-up period. It was found that all patients had good esthetic and functional results after immediate reconstruction. The social activities of patients also were not affected after treatment.

Conclusions

We experienced that segmental mandibulectomy with safe borders and immediate reconstruction with free fibula flap or deep circumflex iliac artery (DCIA) flap is an ideal treatment method for mandibular ameloblastoma. The functional and esthetic results are also detected as very satisfactory for the patients.