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Reconstruction of the Mandible and Choice of Flap

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Management of Oral Cancers

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Abstract

Mandibular reconstruction presents a gamut of challenges to the surgeon, mainly attributable to the complexity of functions it performs and by the virtue of its mere location. The reconstructive strategy should aim for providing optimal functional and aesthetic outcomes. Fundamental to this is understanding the role played by mandible so as to contemplate means of substituting each of its functions while reconstructing.

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References

  1. Jewer DD, Boyd JB, Manktelow RT, Zuker RM, Rosen IB, Gullane PJ, et al. Orofacial and mandibular reconstruction with the iliac crest free flap: a review of 60 cases and a new method of classification. Plast Reconstr Surg. 1989;84:391–405.

    Article  CAS  Google Scholar 

  2. Maurer P, Eckert AW, Kriwalsky MS, Schubert J. Scope and limitations of methods of mandibular reconstruction: a longterm follow-up. Br J Oral Maxillofac Surg. 2010;48:100–4.

    Article  Google Scholar 

  3. Urken ML. Composite free flaps in oro-mandibular reconstruction. Arch Otolaryngol Head Neck Surg. 1991;117:724–32.

    Article  CAS  Google Scholar 

  4. Brown James S, et al. A new classification for mandibular defects after oncological resection. Lancet Oncol. 2016;17(1).

    Google Scholar 

  5. Hidalgo DA. Fibula free flap: a new method of mandible reconstruction. Plast Reconstr Surg. 1989 Jul;84(1):71–9.

    Article  CAS  Google Scholar 

  6. Urken ML, Vickery C, Weinberg H, Buchbinder D, Biller HF. The internal oblique-iliac crest osseomyocutaneous microvascular free flap in head and neck reconstruction. J Reconstr Microsurg. 1989 Jul;5(3):203–14; discussion 215–6. PubMed.

    Google Scholar 

  7. Baker SR, Sullivan MJ. Osteocutaneous free scapular flap for one-stage mandibular reconstruction. Arch Otolaryngol Head Neck Surg. 1988 Mar;114(3):267–77.

    Article  CAS  Google Scholar 

  8. Avery CM. Review of the radial free flap: still evolving or facing extinction? Part two: osteocutaneous radial free flap. Br J Oral Maxillofac Surg. 2010 Jun;48(4):253–60. https://doi.org/10.1016/j.bjoms.2009.09.017.

    Article  CAS  PubMed  Google Scholar 

  9. Kim P, Blackwell K. Latissimus-serratus-rib free flap for oromandibular and maxillary reconstruction. Arch Otolaryngol Head Neck Surg. 2007;133(8):791.

    Article  Google Scholar 

  10. Takushima A, Harii K, Asato H, Momosawa A, Okazaki M, Nakatsuka T. Choice of osseous and osteocutaneous flaps for mandibular reconstruction. Int J Clin Oncol 2005 Aug;10(4):234–42. Review.

    Google Scholar 

  11. Wei F, Yazar S, Lin C, Cheng M, Tsao C, Chiang Y. Double free flaps in head and neck reconstruction. Clin Plast Surg. 2005;32(3):303–8.

    Article  Google Scholar 

  12. Shunyu N, Medhi J, Laskar H, Lyngdoh N, Syiemlieh J, Goyal A. 5th Rib Osteo-pectoralis Major Myocutaneous Flap—Still a viable option for mandibular defect reconstruction. Indian J Otolaryngol Head Neck Surg. 2014;66(4):414–7.

    Article  Google Scholar 

  13. Panje W. Mandible reconstruction with the trapezius osteomusculocutaneous flap. Arch Otolaryngol Head Neck Surg. 1985;111(4):223–9.

    Article  CAS  Google Scholar 

  14. Choung P, Nam I, Kim K. Vascularized cranial bone grafts for mandibular and maxillary reconstruction. J Cranio-Maxillofac Surg. 1991;19(6):235–42.

    Article  CAS  Google Scholar 

  15. Maruyama Y, Urita Y, Ohnishi K. Rib-latissimus dorsi osteomyocutaneous flap in reconstruction of a mandibular defect. Br J Plast Surg. 1985 Apr;38(2):234–7.

    Article  CAS  Google Scholar 

  16. Futran ND, Stack BC Jr, Zaccardi MJ. Preoperative color flow Doppler imaging for fibula free tissue transfers. Ann Vasc Surg. 1998 Sep;12(5):445–50. PMID: 9732422.

    Google Scholar 

  17. Smith RB, Thomas RD, Funk GF. Fibula free flaps: the role of angiography in patients with abnormal results on preoperative color flow Doppler studies. Arch Otolaryngol Head Neck Surg. 2003;129(7):712–5. https://doi.org/10.1001/archotol.129.7.712.

    Article  PubMed  Google Scholar 

  18. Futran ND, Stack BC Jr, Zachariah AP. Ankle-arm index as a screening examination for fibula free tissue transfer. Ann Otol Rhinol Laryngol. 1999 Aug;108(8):777–80.

    Article  CAS  Google Scholar 

  19. Marchetti C, Bianchi A, Mazzoni S, Cipriani R, Campobassi A. Oromandibular reconstruction using a fibula osteocutaneous free flap: four different “preplating” techniques. Plast Reconstr Surg. 2006;118(3):643–51.

    Article  CAS  Google Scholar 

  20. Sharma, et al. Anatomic basis for an algorithmic approach for free fibula flap donor side selection in composite oro-mandibular defects. Indian J Plast Surg. 2015 Jan–Apr;48(1):43–7.

    Article  Google Scholar 

  21. Kang SY, Old MO, Teknos TN. Contour and osteotomy of free fibula transplant using a ruler template. Laryngoscope 2016 Oct;126(10):2288–90. https://doi.org/10.1002/lary.25925. Epub 2016 Mar 12.

  22. Thankappan K, Trivedi NP, Subash P, Pullara SK, Peter S, Kuriakose MA, Iyer S. Three-dimensional computed tomography-based contouring of a free fibula bone graft for mandibular reconstruction. J Oral Maxillofac Surg. 2008 Oct;66(10):2185–92. https://doi.org/10.1016/j.joms.2008.01.035.

    Article  PubMed  Google Scholar 

  23. Goormans F, Sun Y, Bila M, Schoenaers J, Geusens J, Lübbers HT, Coucke W, Politis C. Accuracy of computer-assisted mandibular reconstructions with free fibula flap: results of a single-center series. Oral Oncol 2019 Oct;97:69–75. https://doi.org/10.1016/j.oraloncology.2019.07.022. Epub 2019 Aug 17.

  24. Monaco C, Stranix JT, Avraham T, Brecht L, Saadeh PB, Hirsch D, Levine JP. Evolution of surgical techniques for mandibular reconstruction using free fibula flaps: the next generation. Head Neck 2016 Apr;38(Suppl 1):E2066–73. https://doi.org/10.1002/hed.24380. Epub 2016 Feb 15.

  25. Patel A, Harrison P, Cheng A, Bray B, Bell RB. Fibular reconstruction of the maxilla and mandible with immediate implant-supported prosthetic rehabilitation: jaw in a day. Oral Maxillofac Surg Clin North Am. 2019 Aug;31(3):369–86. doi:https://doi.org/10.1016/j.coms.2019.03.002. Epub 2019 Jun 1. Review.

  26. Chen J, Yin P, Li N, Wu L, Jian X, Jiang C. Functional mandibular reconstruction with double-barrel fibular flap and primary osseointegrated dental implants improve facial esthetic outcome. J Oral Maxillofac Surg. 2019 Jan;77(1):218–225. https://doi.org/10.1016/j.joms.2018.08.008. Epub 2018 Aug 22.

  27. Patel A, Maisel R. Condylar prostheses in head and neck cancer reconstruction. Arch Otolaryngol Head Neck Surg. 2001;127(7):842–846. doi: 10-1001/pubs.Arch Otolaryngol. Head Neck Surg. ISSN-0886-4470-127-7-ooa00194.

    Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Head and Neck Surgery and Oncology, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Ridhi Sood, Krishnakumar Thankappan & Subramania Iyer

  2. Department of Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences & Research Centre, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

    Janarthanan Ramu & Subramania Iyer

Authors
  1. Ridhi Sood
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  2. Janarthanan Ramu
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  3. Krishnakumar Thankappan
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  4. Subramania Iyer
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Editor information

Editors and Affiliations

  1. Former Professor of Otolaryngology, All India Institute of Medical Sciences, New Delhi, India

    Sudhir Bahadur

  2. Centre for Plastic and Reconstructive Surgery, Amrita Institute of Medical Sciences and Research Centre, Kochi, Kerala, India

    Subramania Iyer

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Sood, R., Ramu, J., Thankappan, K., Iyer, S. (2021). Reconstruction of the Mandible and Choice of Flap. In: Bahadur, S., Iyer, S. (eds) Management of Oral Cancers. Springer, Singapore. https://doi.org/10.1007/978-981-15-6499-4_15

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  • DOI: https://doi.org/10.1007/978-981-15-6499-4_15

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-15-6498-7

  • Online ISBN: 978-981-15-6499-4

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