Reconstruction of through-and-through oromandibular defects with combined fibula flap and anterolateral thigh flap

Publication date: Available online 13 December 2016
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Zhao-Jian Gong, Shuai Zhang, Sheng Zhang, Jiang Liu, Yu-Ming Xu, Han-Jiang Wu
PurposeThe reconstruction of massive through-and-through oromandibular defects is still a challenge because no single adequate candidate for a donor site of vascularized bone and a large amount of soft tissue has yet been found. The aim of this study was to evaluate the feasibility and reconstructive efficacy of the combined fibula flap and anterolateral thigh (ALT) flap in tandem for the reconstruction of such defects.Patients and methodsA retrospective case series was performed of patients who had undergone reconstruction of through-and-through oromandibular defects with combined fibula flap and ALT flap in tandem from January 2012 through December 2014 at the Second Xiangya Hospital. The flap design and the methods for defect reconstruction are described, and the reconstructive efficacy is reported.ResultsOf the 14 patients, 13 were men and 1 was a woman, with an average age of 49.36 years. Postoperatively, all flaps survived completely, without vascular compromise or major wound complications. All of the donor sites were closed directly, leaving only linear scars and no thigh or leg motor dysfunctions. All patients were followed for approximately 12–48 months, and the appearance and oral functions were acceptably recovered in about 90% of the patients.ConclusionsBecause of the convenient flap design, satisfactory functional and esthetic results, and lower complication rates at the donor and recipient sites, the use of a combined fibula flap and ALT flap in tandem is a good choice for the reconstruction of complex through-and-through oromandibular defects.



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