The gold standard for mandibular reconstruction is microvascular transfer of fibula. Fibula may be transferred as bone alone or as a skin bone transfer as required.

1. MICROVASCULAR TRANSFER OF FIBULA FOR
MANDIBULAR RECONSTRUCTION
Shailesh Nisal
Amit jaiswal
Parikshit janai
Sparsh Clinics Nagpur India
www.sparshclinics.com

2. WELL DIFFERENTIATED SQUAMOUS CELL
CARCINOMA ALVEOLAR MUCOSA T4 N0 M0

3. WIDE LOCAL EXCISION + BILATERAL NECK
DISSECTION – FLOOR MOUTH, MANDIBULAR
SEGMENT SKIN PADDLE EXCISED

4. PECTORALIS MAJOR MYOCUTANEUS FLAP FOR
LINING

5. OSTEOCUTANEUS FIBULA FOR REPLACEMENT OF
MANDIBLE AND OUTER SKIN PADDLE

6. MANDIBULAR ARCH FORMED IN SITU

10. DONOR AREAS AND FEEDING GASTROSTOMY

11. 2 WKS – HEALING BY PRIMARY INTENSION,
MOUTH OPENING IMPROVING

12. MULTILOCULAR AMELOBLASTOMA MANDIBLE

13. CENTRAL SEGMENT OF BICORTICAL MANDIBLE
FRAGMENTED

14. PLANNING AND MARKINGS

15. MANDIBULAR EXCISION UNDER A BIPEDICLE FLAP
MOVED AS BUCKET-HANDLE

16. EXCISED SPECIMEN

17. VASCULARIZED FIBULA HARVESTED WITH THE
PERONEAL PEDICLE

18. MANDIBULAR OSTEOTOMIES, SHAPING,
STABILIZED WITH TITANIUM MINIPLATES

19. SATISFACTORY HEALING AND GOOD CONTOUR

20. MOUTH CLOSURE AND OPENING

21. THANKS
Shailesh Nisal
Amit Jaiswal
Parikshit Janai
Prashant Bowte
Sparsh Clinics Nagpur India
www.sparshclinics.com