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Fibula free flap for mandibular reconstruction following total en bloc resection in ameloblastoma: a case report and literature review

Abstract

Background: The fibular free flap is considered the gold standard in mandibular bone reconstruction. It has a high survival rate, is well-vascularized, and fits seamlessly into long-bone defects. The purpose of this article is to describe the use of vascularized fibular free flap in mandibular reconstruction after total en bloc resection in case of ameloblastoma suspected of repeated trauma to the mandible.

Case Presentation: A case report of a 26-year-old  patient undergoing a mandibular reconstruction using fibula osteocutenous free flap following total en bloc resection due to ameloblastoma on mandibular symphisis region was monitored using Doppler ultrasound every 15 minutes for three to five days. Within four months of treatment, the patient had improved, and the graft was found to be viable.

Conclusion: The severity and size of the affected tissue, the tumour's histological arrangement, and the consequences were the influence of whether or not ameloblastoma patients should require surgery. To determine the best course of treatment for each individual case of ameloblastoma, an accurate clinical examination and image evaluation are required.

References

  1. Amzerin M, Fadoukhair Z, Belbaraka R, Iraqi M, Boutayeb S, M’Rabti h, Kebdani T, Hassouni K, Benjaafar N, El Gueddari BK, Errihani H. Metastatic Ameloblastoma Responding to Combination Chemotherapy; Case Report and Review of the literature. J Med Case Rep. 2011; 3(5):491.
  2. Brazis PW, Miller NR, Lee AG, Holliday MJ. Neuro-ophthalmologic Aspects of Ameloblastoma. Skull Base Surg. 1995; 5(4):233-44.
  3. Avon SL, McComb J, Clokie C. Ameloblastic Carcinoma: Case Report and Literature Review. J Can Dent Assoc. 2003; 69(9):573-6.
  4. Chauhan DS, Guruprasad Y. Plexiform Ameloblastoma of the Mandible. J Clin Imaging Sci. 2011; 1:61.
  5. Reichart PA, Philipsen HP, Sonner S. Ameloblastoma: Biological Profile of 3677 Cases. Eur J Cancer B Oral Oncol. 1995; 31B(2):86-99.
  6. Kim SG, Jang Hs. Ameloblastoma: a Clinical, Radiographic, and Histopathologic Analysis of 71 cases. Oral Surg Oral med Oral Pathol Oral Radiol Endod. 2011; 91(6):649-53.
  7. Jordan RCK, Speight PM. Current Concepts of Odontogenic Tumors. Diagn Histopathol. 2009;15(6):303-10.
  8. Climent LM, Ciment AJ. Malignant Ameloblastoma Metastatic to Lungs 29 years after Primary Resection. Chest. 2002; 121:1359-61.
  9. Henderson JM, Sonnet JR, Schlesinger C, Ord RA. Pulmonary Metastasis of Ameloblastoma: Case Report and Review of the Literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999; 88(2):170-6.
  10. Bak M, Jacobson AS, Buchbinder D, et al. Contemporary Reconstruction of the Mandible. Oral Oncol. 2010; 46(10):71-6.
  11. Santana V. Anatomia de la Cabeza Para Odontologos. 4th ed. Buenos Aires, Argentina; Madrid: Editorial Medica Panamericana, 2007.
  12. Wong RCW, Tiderman H, Kin L, et al. Biomechanics of Mandibular Reconstruction: a review. Int J Oral Maxillofac Surg 2010; 39(4): 313-19
  13. Mandibular reconstruction using the free vascularized fibula graft: an overview of different modifications. Kokosis G, Schmitz R, Powers DB, Erdmann D. Arch Plast Surg. 2016;43:3–9.
  14. Lonie S, Herle P, Paddle A, Pradhan N, Birch T, Shayan R. Mandibular reconstruction: meta-analysis of iliac- versus fibula-free flaps. ANZ J Surg. 2016;86:337–42.
  15. Wang KH, Inman JC, Hayden RE. Modern concepts in mandibular reconstruction in oral and oropharyngeal cancer. Curr Opin Otolaryngol Head Neck Surg. 2011;19:119–24.
  16. Lin CH, Kudva A. Simultaneous reconstruction of mandibular and maxillary defects using the single free fibular osseocutaneous flap: case series and review of the literature. Ann Plast Surg. 2021;86:428–33.
  17. Bolzoni AR, Pollice A, Nuti M, Baj A, Rossi DS, Beltramini GA. Clinical and functional outcomes of cad/cam mandibular reconstruction with free fibular flap comparing traditional versus micro-invasive intraoral surgical approaches. Journal of Biological Regulators and Homeostatic Agents. 2020;34(5):175-84.
  18. Okay D, Al Shetawi AH, Moubayed SP, Mourad M, Buchbinder D, Urken ML. Worldwide 10-year systematic review of treatment trends in fibula free flap for mandibular reconstruction. J Oral Maxillofac Surg. 2016;74:2526–31.
  19. Wijbenga JG, Schepers RH, Werker PM, Witjes MJ, Dijkstra PU. A systematic review of functional outcome and quality of life following reconstruction of maxillofacial defects using vascularized free fibula flaps and dental rehabilitation reveals poor data quality. J Plast Reconstr Aesthet Surg. 2016;69:1024–36.
  20. Ou Q, Wu P, Zhou Z, Pan D, Tang JY. Complication of osteo reconstruction by utilizing free vascularized fibular bone graft.. BMC Surg. 2020; 20:216.
  21. Hartman EH, Spauwen PH, Jansen JA. Donor-site complications in vascularized bone flap surgery. J Invest Surg. 2002; 15:185–97.
  22. Pellini R, Mercante G, Spriano G. Step-by-Step Mandibular Reconstruction with Free Fibula Flap Modelling. ACTA Otorhinolaryngologica Italica. 2012; 32:405-409
  23. Ohishi M. Management of Mandibula Ameloblastoma the Clinical Basis for Treatment Algorithm. J Oral Maxillofacial Surgery. 1999:37.
  24. Kamran H. Dental Implants. Dalam: Perry DA, Beemsterboer PL, penyunting. Periodontology for the Dental Hygienist. 3rd ed. St Louis: Missouri. 2007:320-49.
  25. Wei FC, Chen hC, Chuang CC, Noordhoff MS: Fibular Osteoseptocutaneous Flap: Anatomic Study and Clinical Application. Plast Reconstr Surg. 1986; 78:191-9.
  26. Berggren A, Weiland AJ, Ostrup LT, Dorfman H: Microvascular Free Bone Transfer with Revascularization of the Medullary and Periosteal Circulation Alone. J Bone Joint Surg. 1982; 64A:73-87.
  27. Jones nF, Swartz WM, Mears DC: The Double-Barrel Free Vascularized Fibular Bone Graft. Plast Reconstr Surg. 1988; 81:378-85.
  28. Hidalgo DA: Fibula Free Flap: A New Method of Mandibular Reconstruction. Plast Reconstr Surg. 1989;84:71-9.

How to Cite

Laksmi, P. P., Tillasman, N. S., Agus Roy Rusly Hariantana Hamid, Rooseno, R. R. N. ., Santosa, A., Saraswati, M. R. ., & Devinta, M. R. S. . (2023). Fibula free flap for mandibular reconstruction following total en bloc resection in ameloblastoma: a case report and literature review. Intisari Sains Medis, 14(3), 1217–1221. https://doi.org/10.15562/ism.v14i3.1928

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Putu Pradnyasanti Laksmi
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Natassya Sandra Tillasman
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Agus Roy Rusly Hariantana Hamid
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Ratna Rayeni Natasha Rooseno
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Agus Santosa
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Made Ratna Saraswati
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Made Ratih Santi Devinta
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