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CC BY-NC-ND 4.0 · Arch Plast Surg 2022; 49(05): 652-655
DOI: 10.1055/s-0042-1756350
Pediatric/Craniomilofacial/Head & Neck: Case Report

Maxillo-mandibular Defect Reconstruction with Bilateral Free Fibula Flaps with Dental Implant Placement and Immediate Loading: A Case Report of the Three-team Approach

David Nazarian 
1   Maxillofacial and Reconstructive Surgery Department, FSBI NMRCO FMBA, Moscow, Russia
,
Aleksei Dikarev 
1   Maxillofacial and Reconstructive Surgery Department, FSBI NMRCO FMBA, Moscow, Russia
,
Mikhail Mokhirev 
1   Maxillofacial and Reconstructive Surgery Department, FSBI NMRCO FMBA, Moscow, Russia
,
Georgy Zakharov 
1   Maxillofacial and Reconstructive Surgery Department, FSBI NMRCO FMBA, Moscow, Russia
,
Alexander Fedosov 
1   Maxillofacial and Reconstructive Surgery Department, FSBI NMRCO FMBA, Moscow, Russia
,
Maksim Potapov 
1   Maxillofacial and Reconstructive Surgery Department, FSBI NMRCO FMBA, Moscow, Russia
,
Mikhail Chernenkiy 
2   Maxillofacial and Reconstructive Surgery Department, NK Clinic, Moscow, Russia
,
Yuriy Vasilev 
3   Radiology Department, Research and Practical Clinical Center of Diagnostics and Telemedicine Technologies, Moscow, Russia
,
Grigoriy Kyalov 
2   Maxillofacial and Reconstructive Surgery Department, NK Clinic, Moscow, Russia
,
Saniyat Chausheva 
4   Plastic Surgery Department, FSBI NMRCO FMBA, Moscow, Russia
,
Arbak Khachatryan 
1   Maxillofacial and Reconstructive Surgery Department, FSBI NMRCO FMBA, Moscow, Russia
,
Artur Tevosyan 
5   Department of clinical medicine, International School “Medicine of the Future”, Sechenov University
,
Gevorg Arakelyan 
5   Department of clinical medicine, International School “Medicine of the Future”, Sechenov University
› Author Affiliations Funding None.
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Abstract

Patients with advanced malignant tumors, including both jaws, is a challenging task for a head and neck surgeon. Current treatment landscape demonstrates good functional, anatomical, and aesthetic results in patients who could previously receive only palliative care. The extensive tissue defects resulting from oncological resections in the head and neck region require immediate reconstruction due to the exposure of vital structures and their contact with the external environment. A patient was operated using a three-team multidisciplinary approach involving simultaneous work of three specialized teams of maxillofacial and reconstructive microsurgeons, as well as an implantologist and a prosthodontist. This approach allowed simultaneous tumor resection with subsequent reconstruction of the intraoperative defect involving bilateral harvesting of two revascularized free fibular osteomusculocutaneous flaps with dental implantation and simultaneous rehabilitation of dentition with crowns.

Keywords

jaw defect - fibula flap - bilateral harvesting - case report - three-team approach

Authors' Contributions

Conceptualization: D.N., A.D., M.M., G.Z., M.C., G.K. Data curation: M.P., S.C., G.A., A.T. Formal analysis: A.K. Methodology: M.M., G.K. Project administration: D.N., A.D., Y.V. Visualization: Y.V., M.C. Writing - original draft: G.A., A.T. Writing - review and editing: D.N., A.K. All authors read and approved the final manuscript.


Ethical Approval

The study was performed in accordance with the principles of the Declaration of Helsinki. Written informed consent was obtained.


Patient Consent

The patient provided written informed consent for the publication and the use of his images.




Publication History

Received: 16 December 2021

Accepted: 17 February 2022

Article published online:
23 September 2022

© 2022. The Korean Society of Plastic and Reconstructive Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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