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Donor site sequela of class III B vascular anomaly following reconstruction of the mandible with free osteoseptocutaneous fibula flap: a case report

Year 2008, Volume: 18 Issue: 6, 367 - 370, 20.12.2008

Samet Vasfi Kuvat Günter Hafız Fatih Kabakaş Atakan Aydın Ayhan Okumuş

Abstract

Free transfer of the fibula for mandibular reconstruction provides desirable functional and aesthetic results. However, unexpected donor- and recipient-site complications may be encountered with most free flap transfer procedures. A 62-year-old woman underwent wide resection and segmental mandibulectomy for low-grade squamous cell carcinoma of intraoral location. Reconstruction of the defect was performed at the same session with an osteoseptocutaneous free flap from the right fibula. A class III B vascular malformation was detected intraoperatively at the donor site, which resulted in restriction of foot inversion and abduction, and of toe extension during the follow-up.

Keywords

Angiography bone transplantation fibula/transplantation leg/blood supply mandibular neoplasms/surgery surgical flaps vascular malformations

References

  • Serafin D. The fibula flap. In: Atlas of microsurgical com- posite tissue transplantation. Philadelphia: Saunders; 1996. p. 547-73.
  • Aydin A, Emekli U, Erer M, Hafiz G. Fibula free flap for mandible reconstruction. Kulak Burun Bogaz Ihtis Derg 2004;13:62-6.
  • Okumus A, Emekli U, Kabakas F, Kuvat SV, Aydin A, Hafiz G, et al. Sculpturing a fibular flap: com- bined horizontal/vertical osteotomy and ostectomy for reconstruction of complex craniofacial defects with one flap. Microsurgery 2005;25:589-95.
  • Taylor GI, Miller GD, Ham FJ. The free vascularized bone graft. A clinical extension of microvascular tech- niques. Plast Reconstr Surg 1975;55:533-44.
  • Hidalgo DA. Fibula free flap mandibular reconstruc- tion. Clin Plast Surg 1994;21:25-35.
  • Hidalgo DA. Fibula free flap: a new method of man- dible reconstruction. Plast Reconstr Surg 1989;84:71-9.
  • Lutz BS, Wei FC, Ng SH, Chen IH, Chen SH. Routine donor leg angiography before vascularized free fibula transplantation is not necessary: a prospective study in 120 clinical cases. Plast Reconstr Surg 1999;103:121-7.
  • Klein S, Hage JJ, van der Horst CM, Lagerweij M. Ankle- arm index versus angiography for the preassessment of the fibula free flap. Plast Reconstr Surg 2003;111:735-43.
  • Disa JJ, Cordeiro PG. The current role of preoperative arteriography in free fibula flaps. Plast Reconstr Surg 1998;102:1083-8.
  • Mast BA. Comparison of magnetic resonance angiog- raphy and digital subtraction angiography for visu- alization of lower extremity arteries. Ann Plast Surg 2001;46:261-4.
  • Sueyoshi E, Sakamoto I, Matsuoka Y, Ogawa Y, Hayashi H, Hashmi R, et al. Aortoiliac and lower extremity arteries: comparison of three-dimensional dynamic contrast-enhanced subtraction MR angiography and conventional angiography. Radiology 1999;210:683-8.
  • Rinker B, Karp NS, Margiotta M, Blei F, Rosen R, Rofsky NM. The role of magnetic resonance imaging in the management of vascular malformations of the trunk and extremities. Plast Reconstr Surg 2003;112:504-10.
  • Klein MB, Karanas YL, Chow LC, Rubin GD, Chang J. Early experience with computed tomographic angiog- raphy in microsurgical reconstruction. Plast Reconstr Surg 2003;112:498-503.

Serbest fibula osteoseptokutan flep ile mandibula rekonstrüksiyonundan sonra verici sahada sınıf III B vasküler anomaliye bağlı sekel: Olgu sunumu

Year 2008, Volume: 18 Issue: 6, 367 - 370, 20.12.2008

Samet Vasfi Kuvat Günter Hafız Fatih Kabakaş Atakan Aydın Ayhan Okumuş

Abstract

Mandibula rekonstrüksiyonunda serbest fibular flep transplantasyonu fonksiyonel ve estetik açıdan iste- nen sonucu verebilen bir seçenektir. Serbest flep transferlerinde alıcı ve verici alanlarda öngörülmeyen istenmeyen sonuçlar her zaman olasıdır. İntraoral düşük dereceli skuamöz hücreli karsinom nedeniyle tümör rezeksiyonu ve segmental mandibulektomi uygulanan 62 yaşında kadın hastaya, aynı seansta sağ fibula osteoseptokutan flep ile rekonstrüksiyon yapıldı. Verici sahada sınıf III B vasküler anomali- si olduğu görülen hastada ameliyat sonrası ayak inversiyon ve abdüksiyonu ile parmak ekstansiyon kısıtlılığı morbiditesi gelişti

Keywords

Anjiyografi kemik transplantasyonu fibula/transplantasyon bacak/kanlanma mandibula neoplazileri/cerrahi cerrahi flep vasküler malformasyon

References

  • Serafin D. The fibula flap. In: Atlas of microsurgical com- posite tissue transplantation. Philadelphia: Saunders; 1996. p. 547-73.
  • Aydin A, Emekli U, Erer M, Hafiz G. Fibula free flap for mandible reconstruction. Kulak Burun Bogaz Ihtis Derg 2004;13:62-6.
  • Okumus A, Emekli U, Kabakas F, Kuvat SV, Aydin A, Hafiz G, et al. Sculpturing a fibular flap: com- bined horizontal/vertical osteotomy and ostectomy for reconstruction of complex craniofacial defects with one flap. Microsurgery 2005;25:589-95.
  • Taylor GI, Miller GD, Ham FJ. The free vascularized bone graft. A clinical extension of microvascular tech- niques. Plast Reconstr Surg 1975;55:533-44.
  • Hidalgo DA. Fibula free flap mandibular reconstruc- tion. Clin Plast Surg 1994;21:25-35.
  • Hidalgo DA. Fibula free flap: a new method of man- dible reconstruction. Plast Reconstr Surg 1989;84:71-9.
  • Lutz BS, Wei FC, Ng SH, Chen IH, Chen SH. Routine donor leg angiography before vascularized free fibula transplantation is not necessary: a prospective study in 120 clinical cases. Plast Reconstr Surg 1999;103:121-7.
  • Klein S, Hage JJ, van der Horst CM, Lagerweij M. Ankle- arm index versus angiography for the preassessment of the fibula free flap. Plast Reconstr Surg 2003;111:735-43.
  • Disa JJ, Cordeiro PG. The current role of preoperative arteriography in free fibula flaps. Plast Reconstr Surg 1998;102:1083-8.
  • Mast BA. Comparison of magnetic resonance angiog- raphy and digital subtraction angiography for visu- alization of lower extremity arteries. Ann Plast Surg 2001;46:261-4.
  • Sueyoshi E, Sakamoto I, Matsuoka Y, Ogawa Y, Hayashi H, Hashmi R, et al. Aortoiliac and lower extremity arteries: comparison of three-dimensional dynamic contrast-enhanced subtraction MR angiography and conventional angiography. Radiology 1999;210:683-8.
  • Rinker B, Karp NS, Margiotta M, Blei F, Rosen R, Rofsky NM. The role of magnetic resonance imaging in the management of vascular malformations of the trunk and extremities. Plast Reconstr Surg 2003;112:504-10.
  • Klein MB, Karanas YL, Chow LC, Rubin GD, Chang J. Early experience with computed tomographic angiog- raphy in microsurgical reconstruction. Plast Reconstr Surg 2003;112:498-503.
There are 13 citations in total.

Details

Primary Language Turkish
Journal Section Case Report
Authors

Samet Vasfi Kuvat This is me

Günter Hafız This is me

Fatih Kabakaş This is me

Atakan Aydın This is me

Ayhan Okumuş This is me

Publication Date December 20, 2008
Published in Issue Year 2008 Volume: 18 Issue: 6

Cite

APA Kuvat, S. V., Hafız, G., Kabakaş, F., Aydın, A., et al. (2008). Serbest fibula osteoseptokutan flep ile mandibula rekonstrüksiyonundan sonra verici sahada sınıf III B vasküler anomaliye bağlı sekel: Olgu sunumu. The Turkish Journal of Ear Nose and Throat, 18(6), 367-370.
AMA Kuvat SV, Hafız G, Kabakaş F, Aydın A, Okumuş A. Serbest fibula osteoseptokutan flep ile mandibula rekonstrüksiyonundan sonra verici sahada sınıf III B vasküler anomaliye bağlı sekel: Olgu sunumu. Tr-ENT. December 2008;18(6):367-370.
Chicago Kuvat, Samet Vasfi, Günter Hafız, Fatih Kabakaş, Atakan Aydın, and Ayhan Okumuş. “Serbest Fibula Osteoseptokutan Flep Ile Mandibula rekonstrüksiyonundan Sonra Verici Sahada sınıf III B vasküler Anomaliye bağlı Sekel: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat 18, no. 6 (December 2008): 367-70.
EndNote Kuvat SV, Hafız G, Kabakaş F, Aydın A, Okumuş A (December 1, 2008) Serbest fibula osteoseptokutan flep ile mandibula rekonstrüksiyonundan sonra verici sahada sınıf III B vasküler anomaliye bağlı sekel: Olgu sunumu. The Turkish Journal of Ear Nose and Throat 18 6 367–370.
IEEE S. V. Kuvat, G. Hafız, F. Kabakaş, A. Aydın, and A. Okumuş, “Serbest fibula osteoseptokutan flep ile mandibula rekonstrüksiyonundan sonra verici sahada sınıf III B vasküler anomaliye bağlı sekel: Olgu sunumu”, Tr-ENT, vol. 18, no. 6, pp. 367–370, 2008.
ISNAD Kuvat, Samet Vasfi et al. “Serbest Fibula Osteoseptokutan Flep Ile Mandibula rekonstrüksiyonundan Sonra Verici Sahada sınıf III B vasküler Anomaliye bağlı Sekel: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat 18/6 (December 2008), 367-370.
JAMA Kuvat SV, Hafız G, Kabakaş F, Aydın A, Okumuş A. Serbest fibula osteoseptokutan flep ile mandibula rekonstrüksiyonundan sonra verici sahada sınıf III B vasküler anomaliye bağlı sekel: Olgu sunumu. Tr-ENT. 2008;18:367–370.
MLA Kuvat, Samet Vasfi et al. “Serbest Fibula Osteoseptokutan Flep Ile Mandibula rekonstrüksiyonundan Sonra Verici Sahada sınıf III B vasküler Anomaliye bağlı Sekel: Olgu Sunumu”. The Turkish Journal of Ear Nose and Throat, vol. 18, no. 6, 2008, pp. 367-70.
Vancouver Kuvat SV, Hafız G, Kabakaş F, Aydın A, Okumuş A. Serbest fibula osteoseptokutan flep ile mandibula rekonstrüksiyonundan sonra verici sahada sınıf III B vasküler anomaliye bağlı sekel: Olgu sunumu. Tr-ENT. 2008;18(6):367-70.