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

Indian J Otolaryngol Head Neck Surg. 2023 Mar;75(1):140-144. doi: 10.1007/s12070-022-03259-y. Epub 2022 Nov 9.

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.

Keywords: Complex oral reconstruction; Free osteo-cutaneous fibula flap; Lateral sural artery free flap; Oral cancer.