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  • Title: Long-term results of partial double-barrel vascularized fibula graft in symphysis for extensive mandibular reconstruction.
    Author: Shen Y, Sun J, Li J, Shi J, Ow A.
    Journal: J Oral Maxillofac Surg; 2012 Apr; 70(4):983-91. PubMed ID: 21778012.
    Abstract:
    PURPOSE: This study aimed to retrospectively review patients who underwent reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis. MATERIALS AND METHODS: Ten patients who underwent reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis (n = 6) and partial double-barrel vascularized fibula graft in the symphysis combined with condylar prosthesis (n = 4) were reviewed. Five patients accepted secondary implantation postoperatively. Measurements of chin labial angle on lateral cephalograms and bone height on panoramic radiographs were performed at 2 years postoperatively in 8 patients. Measurements of chin labial angle were compared with preoperative values. Bone height measurements were compared with measurements obtained preoperatively and at 1 month postoperatively. Eight patients with follow-up greater than 2 years were also asked to rate their satisfaction with their facial appearance. RESULTS: The mean follow-up period was 43.0 months. Bony union and wound healing were observed in all patients during the follow-up period. There was no significant difference in the mean chin labial angle between preoperative measurements and measurements at 2 years postoperatively (P = .128). There was no significant difference in mean bone height between 1 month postoperatively and 2 years postoperatively (P > .05). Eight patients reported that their facial appearance was excellent or good at 2 years postoperatively. CONCLUSIONS: Reconstruction of large mandibular defects with partial double-barrel vascularized fibula graft in the symphysis could not only achieve good facial appearance and function but also maintain soft and hard tissue stability in the long term.
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