Clinical analysis of vascularized fibular graft for the repairment of maxillofacial defects / 中国医师进修杂志

ABSTRACT

[Objective]To explore the application value of vascularized fibular graft in the repairment of maxillofacial defects.[Methods] Forty-five patients with maxillofacial defects caused by various reasons were enrolled and treated by vascularized fibular graft.The related disease history,survival situation of blood vessels and tissue flaps of all the patients were recorded.[Results]All the patients were followed up for 3-6 months after surgery.All the patients could eat by mouth and without no obvious obstacle.There was no facial asymmetry,healthy side bite jaws deflection and so on.The maxillofacial appearance and functions almost returned back to normal.Oral panoramic radiography showed that the osseous healing of transplanted fibular and mandibular was good,and there was no bone nonunion,osteonecrosis,titanium plate rejection or fracture happened.Three-dimensional CT scàn revealed that the recovery of mandibular appearance was good.There was 1 case with leg wound drainage and 1 case with cervical wound effusion,which were all healed after the second phase by dressing change and necessary treatment.The rest of the patients were all healed at the first phase.There was no free tissue flap necrosis and calf obvious dysfunction.[Conclusions] Using vascularized fibular graft for the repairment of maxillofacial defects,the maxillofacial appearance and functions of patients almost return to normal after surgery.The surgery can satisfy the requirements of patients on postoperative oral and maxillofacial appearance and function with lower incidence of complications and hig her survival rate of free tissue flap.Therefore,it is worthy of clinical application.