Archives of Head and Neck Surgery
Archives of Head and Neck Surgery

Combination of surgical techniques and reconstructive devices as an alternative treatment after fibula free flap mandibular reconstruction failure: a case report

Beatrice Mitye Ogusco, Luiza Miguel Simonetti, André Sakima Serrano, Luiz Carlos Ishida, Rafael Tutihashi, Dorival Carlucci, Sérgio Gonçalves

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Loss of mandibular continuity and functionality in cancer patients undergoing extensive mandible resections is challenging. In these situations, the gold standard treatment is fibula free flap reconstruction. The major challenge occurs when there is a failure of the transplanted fibula. Here we report the case of a patient who underwent right hemimandibulectomy with disarticulation and immediate mandibular reconstruction with a fibula free flap. Subsequently, the flap viability was lost, and there was necrosis of the transplanted bone segment in the short-term follow-up. Considering the best form of rehabilitation for the patient, minimizing the risks of loss and optimizing the reconstructive quality, we opted to install a customized prosthesis including a condylecavity joint component associated with a new free flap and subsequent rehabilitation of the dental occlusion with an implant-supported fixed prosthesis.


free tissue flaps; head and neck neoplasms; mandibular prosthesis implantation; mandibular reconstruction; microsurgery; reconstructive surgical procedures.


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