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Microvascular reconstruction of mandibular defects in paediatric patients

Bernardo Bianchi, MD, Andrea Ferri, MD (Resident)Corresponding Author Informationemail address, Silvano Ferrari, MD (Associate Professor), Chiara Copelli, MD (Resident), Alessandra Multinu, MD, Chiara Di Blasio, MD, Enrico Sesenna, MD (Full ProfessorChief)

Received 13 November 2009; accepted 14 May 2010. published online 05 July 2010.
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Summary 

Background

During mandibular reconstruction in paediatric patients special consideration must be given to the issues related to growth when restoration of the mandibular and maxillary relationship is essential for correct development of the facial skeleton, a dynamic process whereby mandibular and maxillary growth are strongly correlated. Wide resections, irradiated fields, infection at the recipient site, and scars are strong indications for using revascularized bone-containing free flaps.

Methods

Five patients were reviewed, with a follow-up ranging from 5 to 11 years. Measurements were performed on frontal and lateral views to assess mandibular angle symmetry, midline deviation and facial angle. Measurements were also made on orthopantomograms to assess differences in growth between the normal and reconstructed sides.

Results

Optimal functional and aesthetic results were obtained.

Conclusions

The data suggest that the reconstructed mandible undergoes growth, and that even if this process is unpredictable, it can be sufficient to allow appropriate development of the face.

Maxillo-Facial Surgery Division, Head and Neck Department (Head: Professor Enrico Sesenna), University and Hospital of Parma, Italy

Corresponding Author InformationAndrea Ferri, Maxillo-Facial Surgery Division, Head and Neck Department, University and Hospital of Parma, via Gramsci 14, 43100 Parma, Italy. Tel.: +39 521703107/09; Fax: +39 521703761.

 The authors disclose any source of funds or financial interest and any commercial associations that might pose or create a conflict of interest with information presented in manuscript.

PII: S1010-5182(10)00125-3

doi:10.1016/j.jcms.2010.05.005