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Chimeric Lateral Supramalleolar Artery Perforator Fibula Free Flap in the Reconstruction of Composite Head and Neck Defects

Massarelli, Olindo M.D., Ph.D.; Gobbi, Roberta M.D., Ph.D.; Biglio, Andrea D.D.S.; Soma, Damiano M.D.; Tullio, Antonio M.D.

Plastic & Reconstructive Surgery: January 2014 - Volume 133 - Issue 1 - p 130–136
doi: 10.1097/01.prs.0000435845.33670.64
Reconstructive: Head and Neck: Ideas and Innovations
Coding Perspective

Summary: The authors evaluate the use of an osteomyocutaneous fibula free flap, combined in a chimeric fashion, with a lateral supramalleolar flap, in 10 patients with composite head and neck defects. All reconstructions were performed successfully. With the exception of one patient who died after disease recurrence, all patients were decannulated and resumed an oral diet. Speech intelligibility was good in seven of 10 patients. Dental implants were used in two of 10 patients, with a total of 10 fixtures placed successfully. The donor site healed without complications in all except one case, where necrosis of the skin graft occurred with fungal infection. The chimeric lateral supramalleolar artery perforator fibula free flap may be a valid option for maximizing the quality of life in patients with composite oromandibular defects.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.

CODING PERSPECTIVE FOR THIS ARTICLE IS ON PAGE 136.

Sassari, Sardinia, Italy

From the Maxillofacial Surgery Department, Azienda Ospedaliero-Universitaria di Sassari.

Received for publication April 16, 2013; accepted July 22, 2013.

Disclosure: None of the authors has a commercial association or financial disclosure that might pose or create a conflict of interest with information presented in this article. No funding was received for this work.

Roberta Gobbi, M.D., Ph.D., Via Vardabasso 7/d, 07100 Sassari, Sardinia, Italy, robertagobbimd@hotmail.com

©2014American Society of Plastic Surgeons