Alternative trials of recipient site vessel in maxillomandibular reconstruction with multisegment fibular flaps including only one pedicle anastomosis.

BACKGROUNDS: The objective of this study is to closely examine the preferred anastomoses of the superior thyroid artery, facial artery, lingual artery, maxillary artery, and superficial temporal artery anastomoses for the reconstruction of maxillomandibular defects caused by firearm injuries. The study will also examine the reasons for choosing these arteries, their advantages and disadvantages, surgical techniques, complications, and their postoperatively clinically and scintigraphically assessable viability.

METHODS

The present study encompasses a cohort of ten patients who sustained maxillomandibular injuries and underwent surgical intervention employing a multisegment fibular flap. In all cases, following bone fixation, microvascular anastomoses were sutured under a microscope using 9-0 nylon sutures. Flap viability was initially assessed clinically; in addition, all patients underwent a bone scan on the fifth day after surgery using an intravenous infusion of Tc-99m methylene diphosphonate (MDP).

RESULTS

In the study, 10 patients who underwent maxillomandibular multisegment flap surgery received the most appropriate microvascular anastomosis for their pathology. Of these patients, the six most demonstrative cases, which best represent the relevant artery used for anastomosis, have been detailed.

CONCLUSIONS

Although the aim of this study was not to establish a definitive algorithm based on the 10 cases presented, it is hypothesised that the findings may provide some guidance to surgeons working in this field.