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Open AccessArticle

Delayed Reconstruction of Palatomaxillary Defect Using Fibula Free Flap

by Soo-Hwan Byun 1,2,3,*, Ho-Kyung Lim 1,4, Byoung-Eun Yang 2,3, Soung-Min Kim 1,5 and Jong-Ho Lee 1,5,6,7
1
Department of Oral & Maxillofacial Surgery, School of Dentistry, Seoul National University, Seoul 03080, Korea
2
Department of Oral & Maxillofacial Surgery, Dentistry, Sacred Heart Hospital, Hallym University College of Medicine, Anyang 14068, Korea
3
Graduate School of Clinical Dentistry, Hallym University, Chuncheon 24252, Korea
4
Department of Oral & Maxillofacial Surgery, Dentistry, Korea University Guro Hospital, Seoul 08308, Korea
5
Oral Cancer Center & Clinical Trial Center, Seoul National University Dental Hospital, Seoul 03080, Korea
6
Dental Research Institute, School of Dentistry, Seoul National University, Seoul 03080, Korea
7
Clinical Translational Research Center for Dental Science, Seoul National University Dental Hospital, Seoul 03080, Korea
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(3), 884; https://doi.org/10.3390/jcm9030884 (registering DOI)
Received: 17 February 2020 / Revised: 19 March 2020 / Accepted: 20 March 2020 / Published: 24 March 2020
(This article belongs to the Special Issue Innovation in Head and Neck Reconstructive Surgery)
Introduction. The objective of this study was to evaluate a surgical technique and to present the results of delayed reconstruction of palatomaxillary defects using fibula free flap (FFF). Methods. A review was conducted for nine patients who underwent palatomaxillary reconstruction using FFF. Primary disease, type of reconstruction, defect area, fibula segment length and number of osteotomies, radiotherapy, and implant installation after FFF reconstruction were analyzed. Results. All nine patients underwent delayed reconstruction. The fibula shaft was osteotomized into two segments in seven patients and three segments in one patient with bilateral Brown’s revised classification IV/d defect. One case was planned by using a computer-aided design computer-aided manufacturing (CAD/CAM) system with a navigation system. The mean length of the grafted fibula bone was 68.06 mm. Dental implant treatment was performed in six patients. Six patients received radiation therapy, and there were no specific complications related to the radiation therapy. In one case, the defect was reconstructed with FFF flow-through from a radial forearm free flap. Conclusion. This clinical study demonstrated that the fibula flap is an ideal donor-free flap in a palatomaxillary defect. Delayed reconstruction using an FFF can reduce the complication and failure rates. View Full-Text
Keywords: reconstruction; palatomaxillary; defect; simulation; osteomyocutaneous flap; fibula free flap; maxilla; 3D printing; CAD/CAM; radiotherapy reconstruction; palatomaxillary; defect; simulation; osteomyocutaneous flap; fibula free flap; maxilla; 3D printing; CAD/CAM; radiotherapy
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Byun, S.-H.; Lim, H.-K.; Yang, B.-E.; Kim, S.-M.; Lee, J.-H. Delayed Reconstruction of Palatomaxillary Defect Using Fibula Free Flap. J. Clin. Med. 2020, 9, 884.

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