Retrospective Comparative Study of Two Types of Vascularized Free Bone Transplantation for Repairing Mandibular Defects

doi:10.13701/j.cnki.kqyxyj.2024.12.005

Abstract

Abstract: Objective: To summarize and analyze the cases of mandibular defects caused by various reasons in the maxillofacial surgery team of our hospital in recent years, and compare the advantages, disadvantages, and clinical effects between vascularized free fibular flap and iliac flap. Methods: A retrospective study was conducted on 59 cases of vascularized free fibular and iliac flaps for repairing mandibular defects. The indications, perioperative information, and prognosis of vascularized free fibular and iliac flaps for repairing mandibular defects were evaluated and compared. Results: Twenty-seven cases of fibular flap and 32 cases of iliac flap survived, and there was no significant difference in general information, facial appearance, and oral function recovery (6 months after surgery) between two groups. There were significant differences in the type and length of mandibular defect, surgical time, ICU hospitalization time, and postoperative hospitalization time. Conclusion: For mandibular angle defects, vascularized free iliac flap repair is prioritized, while for defects crossing the midline, vascularized free fibular flap repair is prioritized. The Brown classification method can effectively guide the selection of bone flap types. For defects larger than 90 mm, priority should be given to fibular repair, and skin islands can be carried simultaneously to repair soft tissue defects. For defects smaller than 90 mm without soft tissue defects, priority should be given to iliac bone repair. For defects smaller than 90 mm with soft tissue defects, tensor fascia lata flap should be carried for repair. The vascularized free iliac flap is significantly better than the vascularized free fibular flap in terms of surgical time, ICU hospital stay, and postoperative hospital stay. Both vascularized free fibular and iliac flaps can effectively restore the patient's facial appearance and oral function without significant differences.

Key words: vascularized free fibular flap, vascularized free iliac bone flap, mandible defect, repair and reconstruction surgery, function and appearance evaluation

ZHOU Wang, LV Weihua, WANG Xiqian, TONG Chunshi, WU Yang, PENG Liwei. Retrospective Comparative Study of Two Types of Vascularized Free Bone Transplantation for Repairing Mandibular Defects[J]. Journal of Oral Science Research, 2024, 40(12): 1059-1064.

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