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Case Reports
. 2010 Dec;30(6):299-302.

Reconstruction of partial maxillary defects with the double-barrel fibula free flap

A Baj  1 , D Ali Youssef, R Monteverdi, B Bianchi, V A Combi, A B Giannì
Affiliations
Case Reports

Reconstruction of partial maxillary defects with the double-barrel fibula free flap

A Baj et al. Acta Otorhinolaryngol Ital. 2010 Dec.

Abstract
in English, Italian

Maxillary reconstruction still remains challenging for surgeons despite the fact that maxilla is a static structure. The correct shape and volume of the reconstruction can guarantee the best result in terms of soft tissue support and functional outcome for the patients restoring three-dimensional support of the mid third. The fibula free flap seems to be the best free flap to apply in this type of reconstruction, partial maxillectomy, in particular, can benefit from reconstruction with the double barrelled fibula free flap. In fact, this shape can provide the best support to cheek tissue and minimize the tendency of upper retraction of the alar base of the nose and lips. Moreover, the free flap, containing bone, can restore a skeletal structure that will provide adequate bony support for osteointegrated implant prosthesis rehabilitation. All these conditions can be achieved with the double barrel fibula flap that we consider a good approach for maxillary reconstruction.

La ricostruzione mascellare resta ancora una sfida per i chirurghi nonostante l'osso mascellare sia una struttura statica. La corretta ricostruzione di forma e volume, ripristinando il supporto tridimensionale del terzo medio del volto del paziente, è in grado di garantire il miglior risultato sia in termini funzionali che di sostegno dei tessuti molli. Il lembo libero di fibula sembra essere il migliore tra i lembi liberi da applicare a questo tipo di ricostruzione, in particolar modo la maxillectomia parziale può beneficiare della ricostruzione mediante lembo libero di perone a doppia barra. Questa forma infatti è in grado di dare un miglior supporto ai tessuti della guancia e di ridurre al minimo la tendenza alla retrazione superiore della base alare del naso e delle labbra. Inoltre un lembo libero contenente osso è in grado di ripristinare una struttura scheletrica che può fornire un adeguato supporto per una riabilitazione protesica su impianti osteointegrati. Tutte le suddette condizioni si possono ottenere mediante un lembo libero di fibula a doppia barra che noi consideriamo un'ottima soluzione per la ricostruzione del mascellare.

Keywords: Bone reconstruction; Fibula free flap; Maxillary reconstruction.

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Figures

Fig. 1.
Fig. 1.
Model of fibula free-flap modelled into a double-barrel flap.
Fig. 2.
Fig. 2.
Intra-operative view of fibula free-flap modelled into a double-barrel.
Fig. 3.
Fig. 3.
Intra-operative view of anastomoses between flap pedicle and facial vessels.
Fig. 4.
Fig. 4.
Computed tomography showing 3D reconstruction of native maxilla with fibula free-flap.
Fig. 5.
Fig. 5.
Pre- and post-operative view of patient showing an optimal support for soft tissues of peri-nasal region and lip.
Fig. 5.
Fig. 5.
Pre- and post-operative view of patient showing an optimal support for soft tissues of peri-nasal region and lip.
See this image and copyright information in PMC

References

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