Skip to main content
SpringerLink
Log in

Reconstruction of Complex Oro-Mandibular Defect Using Free Fibula Flap and Lateral Sural Artery Flap: A Case Series

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Through and through complex oro-mandibular defect usually involves buccal mucosa, mandibular segment, lip, and outer cheek skin. Reconstruction of such extensive three-dimensional defects pose a great challenge to reconstructive surgeons which requires use of two flaps. There are diverse options for such types of defects like use two pedicled flaps, one free flap, one pedicled flap or use of two free flaps. Amongst them the use of dual free flaps is ideal for the reconstruction. Commonly used dual free flaps are free fibula osteocutaneous flap for mandible, buccal mucosal defect and free radial artery flap or antero-lateral flap for cheek defect. The major disadvantages of using these two free flaps include two different sites for flap harvest, more time for harvesting and increased overall surgery time. We present our experience of reconstruction of large oro-mandibular defect using free osteo-cutaneous fibula flap and lateral sural artery free flap from single limb in six patients between January 2019 and December 2020. Minimum follow up was 6 months.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Availability of Data and Materials

Not applicable.

Code Availability

Not applicable.

References

  1. Wei FC, Demirkan F, Chen HC, Chen IH (1999) Double free flaps in reconstruction of extensive composite mandibular defects in head and neck cancer. Plast Reconstr Surg 103:39

    Article  CAS  PubMed  Google Scholar 

  2. Rommel N, Kesting MR, Rohleder NH et al (2018) Surgical management of severe osteoradionecrosis of the mandibular bone by using double free flap reconstruction. J Craniomaxillofac Surg 46:148 (PubMed, Google Scholar)

    Article  PubMed  Google Scholar 

  3. Wong CH, Wei FC (2010) Anterolateral thigh flap. Head Neck 32(4):529–540. https://doi.org/10.1002/hed.21204

    Article  PubMed  Google Scholar 

  4. Kroll SS, Schusterman MA, Reece GP et al (1996) Choice of flap and incidence of free flap success. Plast Reconstr Surg 98:459–463 (PubMed, Google Scholar)

    Article  Google Scholar 

  5. Cavadas PC, Sanz-Giménez-Rico JR, Gutierrez-de la Cámara A, Navarro-Monzonís A, Soler-Nomdedeu S, Martínez-Soriano F et al (2001) The medial sural artery perforator free flap. Plast Reconstr Surg 108:1609–1615

    Article  CAS  PubMed  Google Scholar 

  6. Umemoto Y, Adachi Y, Ebisawa K (2005) The sural artery perforator flap for coverage of defects of the knee and tibia. Scand J Plast Reconstr Surg Hand Surg 39(4):209–212. https://doi.org/10.1080/02844310410004964

    Article  PubMed  Google Scholar 

  7. Heller L, Cole P, Kaufman Y (2008) Cheek reconstruction: current concepts in managing facial soft tissue loss. Semin Plast Surg 22:294–305

    Article  PubMed  PubMed Central  Google Scholar 

  8. Koshima I, Hosoda S, Inagawa K, Urushibara K, Moriguchi T (1998) Free combined anterolateral thigh flap and vascularized fibula for wide, throughand through oromandibular defects. J Reconstr Microsurg 14:529

    Article  CAS  PubMed  Google Scholar 

  9. Qaisi M, Dee R, Eid I, Murphy J, Velasco Martinez IA, Fung H (2019) Reconstruction for complex oromandibular facial defects: the fibula free flap and pectoralis major flap combination. Case Rep Surg 2019:8451213. https://doi.org/10.1155/2019/8451213

    Article  PubMed  PubMed Central  Google Scholar 

  10. Kashiwa K, Kobayashi S, Tono H, Ogino K, Kimura H (2008) Operative technique to harvest an arterial flap from the posterolateral calf region: how can we elevate a lateral gastrocnemius perforating artery flap safely? J Reconstr Microsurg 24(1):057–066

  11. Kosutic D, Pejkovic B, Anderhuber F, Vadnjal-Donlagic S, Zic R, Gulic R, Krajnc I, Solman L, Kocbek L (2012) Complete mapping of lateral and medial sural artery perforators: anatomical study with Duplex-Doppler ultrasound correlation. J Plast Reconstr Aesthet Surg 65(11):1530. https://doi.org/10.1016/j.bjps.2012.04.045

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Not applicable.

Funding

No financial support was taken from anyone. Study is self-funded.

Author information

Authors and Affiliations

  1. Department of General Surgery, A.C.P.M. Medical College, Dhule, Maharastra, 424002, India

    Prashant Moon

  2. Department of ENT and head and neck surgery, Pramukh Swami Medical College and Shri Krishna Hospital, Bhaikaka University, Karamsad, Anand, Gujarat, 388325, India

    Girish S. Mishra & Jaykumar V. Patel

Authors
  1. Prashant Moon
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Girish S. Mishra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jaykumar V. Patel
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jaykumar V. Patel.

Ethics declarations

Conflict of interest

There is no conflict of interest of any of author.

Informed Consent

Informed consents for participation and publication of images are obtained from the patients.

Research Involving Human Participants and/or Animals

We assert that all procedures contributing to this work comply with the ethical standards of the relevant national and institutional guidelines on human experimentation (Institutional Ethics Committee H. M. Patel Centre for Medical Care & Education Karamsad, Gujarat − 388325, Reg. No. ECR/ 331/ Inst/ GJ/ 2013/ RR-16) and with the Helsinki Declaration of 1975, as revised in 2008.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moon, P., Mishra, G.S. & Patel, J.V. Reconstruction of Complex Oro-Mandibular Defect Using Free Fibula Flap and Lateral Sural Artery Flap: A Case Series. Indian J Otolaryngol Head Neck Surg 75, 140–144 (2023). https://doi.org/10.1007/s12070-022-03259-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-022-03259-y

Keywords

Search

Navigation