Reconstruction of the mandible by fibula free flap

Background: The most frequent cause of defect in the mandible is tumor-related surgery. Larger defects or anterior arch defects cause severe morbidity due to disturbances in function and esthetics. Objectives: To assess the outcome of free tissue transfer for mandible reconstruction. Methods: Since 1998 we operated on 11 patients with mandible defects using the fibula flap as the reconstruction method. We performed immediate reconstruction in eight patients after ablative surgery, and late reconstruction due to radiation-induced complications in three. Results: All patients achieved good functional and esthetic outcome. During the follow-up period two patients died of their malignant disease and one patient died from a non-related cause. Although two patients underwent reoperation in the first 3 months after their primary operation due to fixation failure, there were no other major complications. Conclusions: According to the literature and our limited experience, the fibula flap is a safe and reliable option for mandible reconstruction.