Abstract
Free fibula flap is an option for primary restoration after disarticulation mandibular resection. Inset of the masseter, the key mandibular elevator muscle, at the reconstructed mandible has been reported in literature to optimize functional recovery.
A 54-year old male, diagnosed with mandibular ameloblastoma, underwent disarticulation mandibulectomy-condylectomy and reconstruction of the defect by means of a fibular flap.
The neocondyle was formed by the distal portion of the fibula and passively placed directly into the glenoid fossa with preservation of the temporomandibular disc. The deep portion of the masseter was inset at the angle of the reconstructed mandible.
Condylar position was postoperatively evaluated by panoramic radiographs, and the patient was followed up for 36 months. The occlusion, mastication, speech, and cosmesis were evaluated as very satisfactory by the patient.
The free fibula flap with direct seating of the fibular formed neocondyle into the condylar fossa, followed by reinsertion of the deep portion of the masseter muscle, provides acceptable functional reconstruction of the mandibulectomy-condylectomy defect.
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Gravvanis, A., Lagogiannis, G., Kakagia, D. (2022). Reconstruction of Temporomandibular Joint with a Fibula Free Flap. In: Clinical Scenarios in Reconstructive Microsurgery. Springer, Cham. https://doi.org/10.1007/978-3-319-94191-2_23-1
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DOI: https://doi.org/10.1007/978-3-319-94191-2_23-1
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