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DOI: 10.1055/s-0042-1756350
Maxillo-mandibular Defect Reconstruction with Bilateral Free Fibula Flaps with Dental Implant Placement and Immediate Loading: A Case Report of the Three-team Approach
Funding None.Abstract
Patients with advanced malignant tumors, including both jaws, is a challenging task for a head and neck surgeon. Current treatment landscape demonstrates good functional, anatomical, and aesthetic results in patients who could previously receive only palliative care. The extensive tissue defects resulting from oncological resections in the head and neck region require immediate reconstruction due to the exposure of vital structures and their contact with the external environment. A patient was operated using a three-team multidisciplinary approach involving simultaneous work of three specialized teams of maxillofacial and reconstructive microsurgeons, as well as an implantologist and a prosthodontist. This approach allowed simultaneous tumor resection with subsequent reconstruction of the intraoperative defect involving bilateral harvesting of two revascularized free fibular osteomusculocutaneous flaps with dental implantation and simultaneous rehabilitation of dentition with crowns.
Authors' Contributions
Conceptualization: D.N., A.D., M.M., G.Z., M.C., G.K. Data curation: M.P., S.C., G.A., A.T. Formal analysis: A.K. Methodology: M.M., G.K. Project administration: D.N., A.D., Y.V. Visualization: Y.V., M.C. Writing - original draft: G.A., A.T. Writing - review and editing: D.N., A.K. All authors read and approved the final manuscript.
Ethical Approval
The study was performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained.
Patient Consent
The patient provided written informed consent for the publication and the use of his images.
Publication History
Received: 16 December 2021
Accepted: 17 February 2022
Article published online:
23 September 2022
© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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References
- 1 Guzzo M, Locati LD, Prott FJ, Gatta G, McGurk M, Licitra L. Major and minor salivary gland tumors. Crit Rev Oncol Hematol 2010; 74 (02) 134-148
- 2 Licitra L, Karamouzis MV. 2017 ESMO Essentials for Clinicians Head and Neck Cancers. ESMO Press. 2017. . Chapter 10
- 3 Su T, Fernandes R. Microvascular reconstruction of the mandible: an argument for the fibula osteocutaneous free flap. Rev Española Cirugía Oral Maxilofac 2014; 36 (01) 1-8
- 4 Patel A, Harrison P, Cheng A, Bray B, Bell RB. Fibular reconstruction of the maxilla and mandible with immediate implant-supported prosthetic rehabilitation: jaw in a day. Oral Maxillofac Surg Clin North Am 2019; 31 (03) 369-386
- 5 Ferrari S, Perlangeli G, Mammi P. et al. Bilateral harvesting of a fibula free flap: assessment of morbidity. J Craniofac Surg 2018; 29 (08) 2131-2134
- 6 Nanson EM. Synchronous combined abdomino- thoraco-cervical (oesophagectomy). Aust N Z J Surg 1975; 45 (04) 340-348
- 7 Freiberg A, Bartlett GS. Two-team approach to surgery for head and neck cancer. Can J Surg 1980; 23 (01) 35-38
- 8 Torabi SJ, Chouairi F, Dinis J, Alperovich M. Head and neck reconstructive surgery: characterization of the one-team and two-team approaches. J Oral Maxillofac Surg 2020; 78 (02) 295-304
- 9 Crawley MB, Sweeny L, Ravipati P. et al. Factors associated with free flap failures in head and neck reconstruction. Otolaryngol Head Neck Surg 2019; 161 (04) 598-604
- 10 Cheng H, Clymer JW, Po-Han Chen B. et al. Prolonged operative duration is associated with complications: a systematic review and meta-analysis. J Surg Res 2018; 229: 134-144
- 11 Wan M, Zhang JX, Ding Y. et al. High-risk plastic surgery: an analysis of 108,303 cases from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP). Plast Surg (Oakv) 2020; 28 (01) 57-66
- 12 Bauermeister AJ, Zuriarrain A, Newman M, Earle SA, Medina III MA. Impact of continuous two-team approach in autologous breast reconstruction. J Reconstr Microsurg 2017; 33 (04) 298-304
- 13 Marsh D, Patel NG, Rozen WM, Chowdhry M, Sharma H, Ramakrishnan VV. Three routine free flaps per day in a single operating theatre: principles of a process mapping approach to improving surgical efficiency. Gland Surg 2016; 5 (02) 107-114