Stereomodel-Assisted Fibula Flap Harvest and Mandibular Reconstruction

Yeung, Richie W.K.; Samman, Nabil; Cheung, Lim K.; Zhang, Chenping; Chow, Raymond L.K.

doi:10.1016/j.joms.2006.05.067

« Previous Next »Journal of Oral and Maxillofacial Surgery
Volume 65, Issue 6 , Pages 1128-1134, June 2007

Stereomodel-Assisted Fibula Flap Harvest and Mandibular Reconstruction

Richie W.K. Yeung, FRACDS, FRCS(Ed)
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong.
- Address correspondence and reprint requests to Dr Yeung: The University of Hong Kong, Oral and Maxillofacial Surgery, 34 Hospital Road, Prince Philip Dental Hospital, Hong Kong
Nabil Samman, FRCS(Ed), FDSRCS
- Professor and Program Director, Department of Oral and Maxillofacial Surgery, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong.
Lim K. Cheung, PhD, FRACDS(OMS)
- Chair Professor, Department of Oral and Maxillofacial Surgery, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong.
Chenping Zhang, DDS, MD
- Professor, Ninth People’s Hospital, Medical School of Shanghai, Jiao-Tong University, Shanghai, China.
Raymond L.K. Chow, MDS, FHKAM(DS)
- Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Hong Kong, Prince Philip Dental Hospital, Hong Kong.

Purpose

To describe a method for stereomodel-assisted fibula flap harvest and mandibular reconstruction utilizing multiple fibula bony segments.

Materials and Methods

Stereomodels of the mandible and the fibula were obtained from computed tomography scan data. The length of fibula to be harvested was predetermined by measurement of the stimulated of existing mandibular defect on the mandibular stereomodel. A titanium reconstruction plate was shaped to fit the original mandibular contour. The stereomodel fibula was divided into multiple segments and the segments were placed on the mandibular stereomodel in the ideal edentulous position against the upper dentition and simulate the angular contour of the mandible for best comesis. The predetermined bony segments were measured and the system was then transferred to the patient in the operation theater using acrylic locating splints.

Results

Experience with 8 patients (2 primary and 2 secondary reconstructions) indicated that a good clinical outcome in terms of mandibular contour and positions of the reconstructed segment was possible. The outer facial appearance and symmetry were consistently excellent and no instability or malposition of the graft segments was encountered.

Conclusion

Stereomodel-assisted fibula flap harvest and insertion is a worthwhile attempt at improving the results of mandibular reconstruction and deserves further attention.