A primary study on application of neuralized fibula flap for mandibular reconstruction and sensory restoration of the lower lip

doi:10.19438/j.cjoms.2024.02.005

Abstract

Abstract: PURPOSE: To explore a new method of simultaneous jaw reconstruction and sensory recovery after resection of the mandible and inferior alveolar nerve due to tumor, so as to provide reference for clinical practice. METHODS: Segmental resection of mandibular bone was performed in a patient with mandibular ameloblastoma. The inferior alveolar nerve closely associated with the lesion was removed during the operation, neurovascularized fibula free flap was transplanted at the same time. The graft resorption was observed by postoperative imaging, and sensory preservation was evaluated by applying two-point discriminative sensation and touch test using sensory test wire. RESULTS: At the 9-month postoperative follow-up, the patient exhibited a naturally symmetrical facial appearance, with the flap displaying excellent survival and blood supply. The grafted bone remained stable without noticeable resorption, and the lower lip regained good sensory function while sensory function was partially restored to the chin. There were no issues such as lip-biting or salivation. Furthermore, neither recipient nor donor areas exhibited adverse complications. CONCLUSIONS: This innovative approach of simultaneous nerve reconstruction demonstrates promising efficacy in restoring lower lip sensation and preventing postoperative grafted bone resorption in fibula flap transplantation for mandibular reconstruction.

Key words: Fibula flap, Nerve anastomosis, Mandibular defect, Jaw reconstruction

CLC Number:

R782.2

ZHANG Bing-qing, SHI Jing-cun, WU Zi-qian, ZHANG Yu-han, WANG Jie-yu, XIAO Meng, WANG Lei. A primary study on application of neuralized fibula flap for mandibular reconstruction and sensory restoration of the lower lip[J]. China Journal of Oral and Maxillofacial Surgery, 2024, 22(2): 143-147.

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