Revolutionizing Adult Micrognathia Treatment: Should Free Fibular Flap Become an Option?

The management of micrognathia in adults necessitates intricate surgical procedures. A vascularized bone graft, notably the free fibular flap (FFF), offers a novel viable solution for repairing significant defects. However, the limited utilization of FFF in adult micrognathia contributes to gaps in understanding its outcomes. A retrospective case series of 2 patients aged 28 and 65, with severe micrognathia due to neglected trauma and osteoradionecrosis, underwent refracture and reconstruction with FFF. Intraoperatively, no significant complications occurred. The FFF were molded to fit the gaps of refractured mandible sites, with similar surgical approaches for both patients. Upon 3 months' follow up, their quality of life (QoL), structural changes, and sensation alterations were assessed and showed promising results. The sensory impairment caused did not hinder the quality of life. Thus, the free fibular flap demonstrates promising outcomes as the initial treatment for adult micrognathia, yielding minimal morbidities and significant functional and anatomic improvements.