Mair Manish, Rajaram Kartic, Baker Andrew
Department of Maxillofacial Surgery, University Hospital of Leicester, Leicester, UK.
J Maxillofac Oral Surg. 2024 Feb;23(1):53-55. doi: 10.1007/s12663-021-01567-4. Epub 2021 May 11.
Free fibula flap has been the workhouse of reconstruction for segmental mandibular defects. The use of computer aided design helps in achieving the desired aesthetic and functional outcome. It has its advantages but it comes with an extensive financial burden.
We propose the use of redundant proximal fibula bone segment as a template and a cutting guide for flap osteotomies in mandibular reconstruction.
We have used this surgical technique in a case of T4 oral cancer that required segmental mandibulectomy.
Average ischaemia time was 1 hour and 30 minutes. Based on histopathology report, both the patients required adjuvant radiotherapy. Oral competence was maintained in both the patients. Post-operatively, the contour and the orientation of the mandibular reconstruction were comparable both clinically and radiologically to the previously planned 3D cases.
This surgical technique provides an accurate guide for end angle osteotomy. In addition, it does not require any extra surgical step and does not increase the ischemia time of the flap with no additional extra cost.
The online version contains supplementary material available at 10.1007/s12663-021-01567-4.
游离腓骨瓣一直是节段性下颌骨缺损重建的常用方法。计算机辅助设计有助于实现理想的美学和功能效果。它有其优点，但也带来了巨大的经济负担。
我们建议使用多余的近端腓骨骨段作为模板和切割导向器，用于下颌骨重建中的皮瓣截骨术。
我们已在1例需要进行节段性下颌骨切除术的T4期口腔癌病例中使用了这种手术技术。
平均缺血时间为1小时30分钟。根据组织病理学报告，两名患者均需要辅助放疗。两名患者均保持了口腔功能。术后，下颌骨重建的轮廓和方向在临床和影像学上与先前计划的3D病例相当。
这种手术技术为末端角度截骨术提供了准确的导向。此外，它不需要任何额外的手术步骤，不会增加皮瓣的缺血时间，也不会产生额外费用。
在线版本包含可在10.1007/s12663-021-01567-4获取的补充材料。
