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Bilateral Harvesting of a Fibula Free Flap

Assessment of Morbidity

Ferrari, Silvano, MD*; Perlangeli, Giuseppe, MD*; Mammi, Patrizia, MD; Varazzani, Andrea, MD*; Bianchi, Bernardo, MD*; Fusetti, Stefano, MD, DMD; Brevi, Bruno Carlo, MD§; Ferri, Andrea, MD*

doi: 10.1097/SCS.0000000000004674
Clinical Studies

Purpose: To investigate morbidity related to harversting of bilateral fibula free flap for head and neck reconstruction using subjective and functional tests.

Methods: Patients were retrospectively evaluated using point evaluation system (PES) and balance evaluation systems test (BESTest) questionnaires to assess morbidity related to surgery.

Results: Five patients were enrolled in the study. Mean PES scores was 22.2 over 24. Mean overall function assessed with BESTest was 77.6%, and the results were poorest for section I. Sections V and VI had scores of 88% and 83%, respectively, indicating that the sensory balance and gait stability of the patients were compromised only minimally.

Conclusion: Bilateral harvesting of the fibula free flap is not associated with an increase in long-term morbidity and does not lead to significant functional impairments. Therefore, this procedure should be considered safe, and can be performed without concern regarding morbidity, when bone reconstruction with a fibula free flap is indicated.

*Maxillo-Facial Surgery Division, Head and Neck Department

Rehabilitation Department, University Hospital of Parma, Parma

Maxillofacial Surgery Unit, Department of Neuroscience, University of Padova Medical School, Padova

§Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Pisa, Pisa, Italy.

Address correspondence and reprint requests to Andrea Varazzani, MD, Maxillo-Facial Surgery Division, Head and Neck Department, via Gramsci 14, 43100 Parma, Italy; E-mail:

Received 16 November, 2017

Accepted 16 April, 2018

The authors report no conflicts of interest.

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© 2018 by Mutaz B. Habal, MD.