Immediate reconstruction with fibula free flap in patients with mandibular ameloblastoma

ABSTRACT

Management of ameloblastoma has been controversial because of the unique biologic behavior of this neoplasm as a slow-growing, locally invasive tumor with a high rate of recurrence. Recurrence rates of ameloblastoma are reportedly as high as 15% to 25% after radical treatment and 75% to 90% after conservative treatment. With the advancement of craniofacial surgical techniques, use of free flaps for mandibular reconstruction, and dental rehabilitation [such as osseointegration] the surgical management of mandibular Ameloblastoma has become more convincing. The aim of this article is to evaluate the clinical results of the patients with mandibular ameloblastoma who were treated with segmental mandibulectomy and immediate reconstruction with free flaps. Ten patients with primary ameloblastoma treated at Oral and Maxillofacial Surgery Department of Liaquat National Hospital from 2006 to 2010 were included. The average age of the patients was 36.3 years [range, 24-54 years]. Clinical information radiographs OPG [Orthopantomogram] and CT Scans were obtained. All the tumors were located in the posterior region of the mandible and confirmative diagnosis was made on histopathological examination of the biopsy specimen. We present 10 patients of mandibular ameloblastoma who had segmental mandibulectomy and immediate reconstruction with fibula free flap preformed. The average age of the patients was 36.3 years [range, 24-54 years]. There were 8 male and 2 female patients. All presented with the multilocular radiolucency in the posterior mandible. The patients were followed for a mean period of 22.4 months [range, 12-36 months]. All flaps survived. Recurrence was not detected during the mean follow-up period of 22.4 months. It was noted that all patients had remarkable changes in their function and esthetics after immediate reconstruction. We experienced that segmental mandibulec-tomy with safe borders and immediate reconstruction with fibula free-flap is an ideal reconstruction method for mandibular ameloblastoma