Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UFRGS |
Texto Completo: | http://hdl.handle.net/10183/231552 |
Resumo: | Background: The mandible is responsible for vital functions of the stomatognathic system, and its loss results in functional and aesthetic impairment. Mandibular reconstruction with free fibula flap is considered the gold standard for mandibular reconstruction. Case presentation: We describe here the 38-year follow-up of the patient who was the first case of mandibular reconstruction with free fibula flap reported in the literature. The original report describes a 27-year-old woman who had undergone extensive mandibulectomy due to an osteosarcoma. A microvascularized fibula flap was used for mandibular reconstruction in 1983. Two years later, a vestibulo-lingual sulcoplasty with skin graft was performed to allow the construction of a total dental prosthesis. Fifteen years after the initial treatment, an autologous iliac crest graft was placed in the fibula flap, aimed at increasing bone thickness and height for rehabilitation with implant supported prosthesis. In 2015, a rib graft was positioned in the mental region, enhancing the support to the soft tissues of the face and improving the oral function. A recent review of the patient shows well-balanced facial morphology and optimal functional results of the procedure. Conclusions: The fibula flap method, described in 1975 and first reported for mandibular reconstruction in 1985, continues to be applied as originally described, especially where soft tissue damage is not extensive. Its use in reconstructive surgery was expanded by advancements in surgery and techniques such as virtual surgical planning. However, there is still a lack of evidence related to the long-term evaluation of outcomes. The present work represents the longest-term follow-up of a patient undergoing mandibular reconstruction with free vascularized fibula flap, presenting results showing that, even after 38 years, the procedure continues to provide excellent results. |
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Puricelli, EdelaChem, Roberto Correa2021-11-04T04:24:39Z20211746-160Xhttp://hdl.handle.net/10183/231552001133273Background: The mandible is responsible for vital functions of the stomatognathic system, and its loss results in functional and aesthetic impairment. Mandibular reconstruction with free fibula flap is considered the gold standard for mandibular reconstruction. Case presentation: We describe here the 38-year follow-up of the patient who was the first case of mandibular reconstruction with free fibula flap reported in the literature. The original report describes a 27-year-old woman who had undergone extensive mandibulectomy due to an osteosarcoma. A microvascularized fibula flap was used for mandibular reconstruction in 1983. Two years later, a vestibulo-lingual sulcoplasty with skin graft was performed to allow the construction of a total dental prosthesis. Fifteen years after the initial treatment, an autologous iliac crest graft was placed in the fibula flap, aimed at increasing bone thickness and height for rehabilitation with implant supported prosthesis. In 2015, a rib graft was positioned in the mental region, enhancing the support to the soft tissues of the face and improving the oral function. A recent review of the patient shows well-balanced facial morphology and optimal functional results of the procedure. Conclusions: The fibula flap method, described in 1975 and first reported for mandibular reconstruction in 1985, continues to be applied as originally described, especially where soft tissue damage is not extensive. Its use in reconstructive surgery was expanded by advancements in surgery and techniques such as virtual surgical planning. However, there is still a lack of evidence related to the long-term evaluation of outcomes. The present work represents the longest-term follow-up of a patient undergoing mandibular reconstruction with free vascularized fibula flap, presenting results showing that, even after 38 years, the procedure continues to provide excellent results.application/pdfengHead & face medicine. London. Vol. 17 (2021), 46, [9 p.]Reconstrução mandibularMicrocirurgiaFíbulaMandibular reconstructionFree vascularized fibula graftMicrosurgeryLong-term follow-upThirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flapEstrangeiroinfo:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UFRGSinstname:Universidade Federal do Rio Grande do Sul (UFRGS)instacron:UFRGSTEXT001133273.pdf.txt001133273.pdf.txtExtracted Texttext/plain36994http://www.lume.ufrgs.br/bitstream/10183/231552/2/001133273.pdf.txt6870e3e186cb8bf82d6b7489328b45d6MD52ORIGINAL001133273.pdfTexto completo (inglês)application/pdf6076286http://www.lume.ufrgs.br/bitstream/10183/231552/1/001133273.pdff0c2a607e5088acdea4d2d02e7a524b5MD5110183/2315522021-11-20 06:19:49.304031oai:www.lume.ufrgs.br:10183/231552Repositório de PublicaçõesPUBhttps://lume.ufrgs.br/oai/requestopendoar:2021-11-20T08:19:49Repositório Institucional da UFRGS - Universidade Federal do Rio Grande do Sul (UFRGS)false |
dc.title.pt_BR.fl_str_mv |
Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap |
title |
Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap |
spellingShingle |
Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap Puricelli, Edela Reconstrução mandibular Microcirurgia Fíbula Mandibular reconstruction Free vascularized fibula graft Microsurgery Long-term follow-up |
title_short |
Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap |
title_full |
Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap |
title_fullStr |
Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap |
title_full_unstemmed |
Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap |
title_sort |
Thirty-eight-year follow-up of the first patient of mandibular reconstruction with free vascularized fibula flap |
author |
Puricelli, Edela |
author_facet |
Puricelli, Edela Chem, Roberto Correa |
author_role |
author |
author2 |
Chem, Roberto Correa |
author2_role |
author |
dc.contributor.author.fl_str_mv |
Puricelli, Edela Chem, Roberto Correa |
dc.subject.por.fl_str_mv |
Reconstrução mandibular Microcirurgia Fíbula |
topic |
Reconstrução mandibular Microcirurgia Fíbula Mandibular reconstruction Free vascularized fibula graft Microsurgery Long-term follow-up |
dc.subject.eng.fl_str_mv |
Mandibular reconstruction Free vascularized fibula graft Microsurgery Long-term follow-up |
description |
Background: The mandible is responsible for vital functions of the stomatognathic system, and its loss results in functional and aesthetic impairment. Mandibular reconstruction with free fibula flap is considered the gold standard for mandibular reconstruction. Case presentation: We describe here the 38-year follow-up of the patient who was the first case of mandibular reconstruction with free fibula flap reported in the literature. The original report describes a 27-year-old woman who had undergone extensive mandibulectomy due to an osteosarcoma. A microvascularized fibula flap was used for mandibular reconstruction in 1983. Two years later, a vestibulo-lingual sulcoplasty with skin graft was performed to allow the construction of a total dental prosthesis. Fifteen years after the initial treatment, an autologous iliac crest graft was placed in the fibula flap, aimed at increasing bone thickness and height for rehabilitation with implant supported prosthesis. In 2015, a rib graft was positioned in the mental region, enhancing the support to the soft tissues of the face and improving the oral function. A recent review of the patient shows well-balanced facial morphology and optimal functional results of the procedure. Conclusions: The fibula flap method, described in 1975 and first reported for mandibular reconstruction in 1985, continues to be applied as originally described, especially where soft tissue damage is not extensive. Its use in reconstructive surgery was expanded by advancements in surgery and techniques such as virtual surgical planning. However, there is still a lack of evidence related to the long-term evaluation of outcomes. The present work represents the longest-term follow-up of a patient undergoing mandibular reconstruction with free vascularized fibula flap, presenting results showing that, even after 38 years, the procedure continues to provide excellent results. |
publishDate |
2021 |
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2021 |
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Head & face medicine. London. Vol. 17 (2021), 46, [9 p.] |
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