Reconstruction of the mandible

Abstract

Segmental mandibulectomy leads to a great deficit in the form and function of the patient. Vascularised bone flaps have become the choice of the method of reconstruction of the mandible in an oncologic setting. Fibula osseous or oseteocutaneous flaps have become the favored method in centers across the world. This article reviews certain pertinent and practical points with regards to fibula flap reconstruction of the mandible. Methods of osteosynthesis, merits of inclusion of the FHL muscle in the flap and use of osteointegrated implants are discussed in detail. The reader will also be able at the end to understand the role of pre operative vascular imaging, steps taken when there is an irreversible flap failure and steps to maintain and rehabilitate occlusion as practiced in the author′s service