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Mandible Reconstruction with Fibula Free Flap. Is this an option?
Head & Neck Cancer | Last Active: Oct 23 3:41pm | Replies (58)Comment receiving replies
I had the Mandible Reconstruction with Fibula Free Flap surgery done last year in 2023. It was a rough time, the first interior flap failed due to an infection and they did another skin graft from my radial fore arm. Not to go into a lot of detail but surgeon cleared me early this year to proceed with prosthetic teeth, I have only one original tooth in my lower jaw. Oral surgeon had to thin the tissue to make way for the implants and in doing so exposed the bone and some of the hardware which is not healing. I was then advised that one of the fibular segments did not heal, so their is no blood supply which is causing the tissue not to grow back over and cover. I was informed today that I would have to go through the procedure again from the original surgeon that performed the first procedure. A little more history had oral cancer 8 years ago with chemo and radiation which developed into Osteoradionecrosis. I am currently cancer free. I have been on a liquid diet since March 2023. I am looking for the top 5 surgeons or surgical teams in the country that do this type of procedure for a second opinion.
Replies to "I had the Mandible Reconstruction with Fibula Free Flap surgery done last year in 2023. It..."
Dear ld1262,
I'm not sure where you're located, but if you're anywhere near the East Coast, you might want to speak to: (1) Mark Urken, MD and Eric Genden, MD; both are at Mt. Sinai Hospital (New York City), and (2) Gregory Farwell, MD at Penn Medicine (Philadelphia).
I wish you the very best.
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hi @ld1262 Welcome to the Head and Neck group. Ouch! Third time? I would definitely find a different health center with experience. If the surgeons haven't done at least fifty of these, run away. And yes you are allowed to ask and you should. This is your mandible, not theirs. The micro surgery involved in the reconstruction is the most critical part and must be done by a steady, knowledgable surgeon.
I had fibula free flap used for mandible reconstruction in 2020, also due to osteoradionecrosis from cancer treatment like you. Successful. Had some infection due to excess flap material growing around the prosthetic teeth which had to be dealt with, twice. Aside from that, I'm doing great. Surgery done at Mayo, Rochester by the folks who pretty much perfected this and train others worldwide.
You might want to consider not having pegs for teeth and just get the jaw repair done. Seek out the best is all I can tell you. If you have further questions, there are several of us here who have had this rare procedure. So feel free to reach out and ask.