Head and neck surgery reconstruction with fibula free flap

Introduction: Although considered a “gold standard” procedure for surgical reconstruction of segmental resection of the mandible due to neoplasia, the fibula flap still represents a great challenge from the reconstructive point of view, and there are few studies with descriptions of the surgical results observed in large centers, particularly in developing countries. Objectives: To describe the evolution and surgical outcomes of cancer patients undergoing segmental mandibulectomy with mandible reconstruction using a fibula flap. Method: A longitudinal and retrospective study that analyzed the data of 16 patients who underwent mandibulectomy with fibula free flap reconstruction, treated between 2014 and 2020, at the head and neck surgery service of the University Hospital of the Pontifical Catholic University of Campinas, Brazil Results: The patients’ mean age was 46.7±18.0 years, of whom 75% were male. The type of neoplasm with involvement of the mandible was squamous cell carcinoma in 10 (62.5%) cases, ameloblastoma in 3 (18.7%) cases, and chondrosarcoma, primitive neuroectodermal tumor, and delayed reconstruction after oncologic surgery – each with one case. There were local complications in the postoperative period in 9 cases and, in two, there were complications in the donor area. Two patients died in the immediate postoperative period due to infectious complications. The surgical success rate was 87.5%. Conclusion: It was observed that the rates of local complications and flap survival, as well as complications in the donor area in this group of patients are similar to those of specialized centers for reconstructive head and neck surgery. The complexity of the procedure reinforces the need to increase the number of services in order to contribute to a better evaluation of outcomes and to advance in the learning of the technique and contribute to knowledge in the area.