• José Francisco Gallegos-Hernández and Agustin Martinez-Miramón.
• Departamento de Tumores de Cabeza y Cuello, Hospital de Oncología, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México DF, México. gal61@prodigy.net.mx
• Gac Med Mex. 2008 Mar 1; 144 (2): 859085-90.

BackgroundFibular-free-flap is currently considered the optimum choice in mandible reconstruction.ObjectiveAssess our results using this technique after 10 years-experience.Material And MethodsPatients underwent mandibulectomy and primary or secondary reconstruction with fibular-free-flap between 1995 and 2005. Variables analyzed included: surgical time, time of micro-vascular anastomosis, bleeding, tobacco history, comorbidity, chemo-radiotherapy background, flap type and primary or secondary reconstruction.ResultsWe included, 60 patients and performed 62 flaps. We included 27 women and 33 men; mean age was 43 years, 30 had malignant tumors and 30 benign. Diabetes was the most frequent co-morbid pathology. In 49 subjects reconstruction was primary and secondary in 11; in 38 the flap was osseous and in 22 osteocutaneous. In 52 patients (87%) the flap was successful and 8 showed total loss. The most frequent complications were osteosynthesis material exposure, pseudoarthrosis and cervical abscess. Four patients were subjected to re-exploration but the flap was preserved in all. No acssociation was found among any of the variables studied and flap viability. The functional result was considered adequate in 90% of cases and was associated with time of reconstruction.ConclusionFibular-free-flap is a safe alternative in mandible reconstruction. Primary reconstruction offers better functional results.

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