Reconstruction of mandibular defects using vascularized fibular osteomyocutaneous flap combined with nonvascularized fibular flap

Background: The height of single-layer fibular flap is not long enough to return to the ideal height of the mandible. While the double-layer vascularized fibular osteomyocutaneous flap(VFF) is more complicated in shaping and fixation, along with a longer operation time. The aim of this study was to investigate the clinical effect of VFF combined with nonvascularized fibular flap(NVFF) in the reconstruction of mandibular defect. Material and Methods: From September 2016 to June 2018, 15 patients with benign mandibular tumors underwent reconstruction with VFF and NVFF. SimPlant Pro (TM) software (version 11.04) was used to simulate reconstruction of the mandible preoperatively. Results: All patients were followed up for 8-23 month, with an average of 11.7 months 15 VFFs survived well. Among the 15 NVFFs, one was almost completely absorbed, two with partial absorption, and the remaining survived regardless of the small amount of absorption. The postoperative absorption of the whole fibula was 7.53 +/- 6.362%, a favorable facial contour and speech function were attained. Conclusions: The VFF combined with NVFF to reconstruct the mandibular defect can restore the vertical height of the mandible and achieve satisfactory clinical results.