La ricostruzione della mandibola con lembi microchirurgici: Lembo libero di radio e lembo libero di perone a confronto

Free osteocutaneous flaps have undoubtedly become the elective option in jaw reconstruction after "commando" operations, by reason of both functional and cosmetic outcome and because complementary postoperative radiation therapy can be performed without interfering with the reconstruction. It has nevertheless become clear to even the least expert surgeons that the achievement of satisfactory results is often a distant goal in the presence of extensive resection of soft intra- and/or extraoral parts associated with total or subtotal mandibulectomy. In our case study, 15 free flaps were raised in the same number of patients. Eight free osteofasciocutaneous forearm flaps (Chinese flaps) and 7 free osteofasciocutaneous fibula flaps were raised to reconstruct jaw segments of various dimensions. Fourteen patients presented malignant tumours and one patient was affected by chronic osteomyelitis of the horizontal crus of the jaw. One patient deceased on day six through hemorrhage from a stress-related gastric ulcer. Partial necrosis of a free fibula flap occurred in another case.