Department of Otolaryngology - Head and Neck Surgery, The James Cancer Hospital and Solove Research Institute, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Ann Otol Rhinol Laryngol. 2021 Feb;130(2):219-222. doi: 10.1177/0003489420946782. Epub 2020 Jul 24.
Extensive mandibulofacial defects can be challenging to reconstruct. We present the case of a complex mandibulofacial defect reconstructed with a mega, chimeric fibula free flap.
Ablation of the oral cavity tumor resulted in a large defect involving mandible, floor of mouth, and tongue. Skin of the chin and neck as well as the lower lip were also resected. A fibula free flap was harvested with the skin paddle involving most of the lateral compartment.
The fibula free flap was split into proximal (80 cm) and distal (120 cm) skin paddle islands, which were supplied by separate perforators off the peroneal artery. The intraoral soft tissue defect was reconstructed with the proximal skin paddle while the skin was recreated with the distal skin paddle. A Karapandzic flap was used to reconstruct the lower lip.
The traditional fibula free flap skin paddle often does not provide sufficient soft tissue coverage for large mandibulofacial defects. Some surgeons opt to harvest a second free flap. We describe our technique for using the mega fibula free flap - one of the largest reported in the literature - as a single mode of reconstruction.
广泛的颌面部缺损的重建极具挑战性。我们报告了一例使用大型嵌合腓骨游离皮瓣重建复杂颌面部缺损的病例。
口腔肿瘤的消融导致涉及下颌骨、口底和舌的大面积缺损。颏部和颈部的皮肤以及下唇也被切除。采集了一个包含大部分外侧间隔的皮瓣腓骨游离皮瓣。
腓骨游离皮瓣分为近端（80cm）和远端（120cm）皮瓣岛，由腓动脉的单独穿支供应。用近端皮瓣重建口内软组织缺损，用远端皮瓣重建皮肤。用 Karapandzic 皮瓣重建下唇。
传统的腓骨游离皮瓣皮瓣通常不能为大的颌面部缺损提供足够的软组织覆盖。一些外科医生选择采集第二个游离皮瓣。我们描述了我们使用 mega 腓骨游离皮瓣（文献中报道的最大之一）作为单一重建模式的技术。
