Facial Contouring in Mandibular Reconstruction Using a Proximal Perforator Flap in Free Fibula Transfer

DOI
  • MIYAKE Shiho
    Department of Plastic and Reconstructive Surgery, University of Tsukuba
  • SASAKI Kaoru
    Department of Plastic and Reconstructive Surgery, University of Tsukuba
  • MYOJO Risa
    Department of Plastic and Reconstructive Surgery, University of Tsukuba
  • SASAKI Masahiro
    Department of Plastic and Reconstructive Surgery, University of Tsukuba
  • OSHIMA Junya
    Department of Plastic and Reconstructive Surgery, University of Tsukuba
  • SHIBUYA Yoichiro
    Department of Plastic and Reconstructive Surgery, University of Tsukuba
  • AIHARA Yukiko
    Department of Plastic and Reconstructive Surgery, University of Tsukuba
  • SEKIDO Mitsuru
    Department of Plastic and Reconstructive Surgery, University of Tsukuba

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Other Title
  • Proximal perforatorを用いた遊離腓骨皮弁による下顎再建術の1例

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Abstract

<p>   Free fibula flap transfer, which consists of a vascularized segment of the long fibula, is the gold standard for mandibular reconstruction; however, this flap lacks sufficient soft tissue. In this report, we present a case of mandibular reconstruction in which the free fibula flap included two skin paddles vascularized by the proximal perforator（PP）and distal perforator（DP）. The two skin paddles provided sufficient soft tissue and improved the outcome in terms of reconstructing the facial contours with a single flap. The PP has anatomical variations in terms of（a）location, running through both musculo- and septo-cutaneous regions, and（b）bifurcation, originating from the peroneal artery or more proximal positions. As skin paddles involving the PP have slightly thicker fat tissue and larger soleus muscle tissue than those involving DP, they may be useful for supplying soft tissue in mandibular reconstruction.</p>

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