Long-term results of partial double-barrel vascularized fibula graft in symphysis for extensive mandibular reconstruction

Abstract

Purpose: This study aimed to retrospectively review patients who underwent reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis. Materials and Methods: Ten patients who underwent reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis (n = 6) and partial double-barrel vascularized fibula graft in the symphysis combined with condylar prosthesis (n = 4) were reviewed. Five patients accepted secondary implantation postoperatively. Measurements of chin labial angle on lateral cephalograms and bone height on panoramic radiographs were performed at 2 years postoperatively in 8 patients. Measurements of chin labial angle were compared with preoperative values. Bone height measurements were compared with measurements obtained preoperatively and at 1 month postoperatively. Eight patients with follow-up greater than 2 years were also asked to rate their satisfaction with their facial appearance. Results: The mean follow-up period was 43.0 months. Bony union and wound healing were observed in all patients during the follow-up period. There was no significant difference in the mean chin labial angle between preoperative measurements and measurements at 2 years postoperatively (P =.128). There was no significant difference in mean bone height between 1 month postoperatively and 2 years postoperatively (P >.05). Eight patients reported that their facial appearance was excellent or good at 2 years postoperatively. Conclusions: Reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis could not only achieve good facial appearance and function but also maintain soft and hard tissue stability in the long term. © 2012 American Association of Oral and Maxillofacial Surgeons.