Condyle dislocation following mandibular reconstruction using a fibula free flap: complication cases
10.1186/s40902-019-0197-1
- Author:
Sang Hoon KANG
1
;
Sanghoon LEE
;
Woong NAM
Author Information
1. Department of Oral and Maxillofacial Surgery, Yonsei University, College of Dentistry, 50 Yonsei-ro, Seodaemun-gu, Seoul, 03722 Republic of Korea. omsnam@yuhs.ac, omsnam@naver.com.
- Publication Type:Case Report
- Keywords:
Mandibular reconstruction;
Complication;
Condyle dislocation;
Fibular free flap
- MeSH:
Dislocations;
Fibula;
Free Tissue Flaps;
Humans;
Incidence;
Mandible;
Mandibular Condyle;
Mandibular Reconstruction;
Prognosis;
Surgeons
- From:Maxillofacial Plastic and Reconstructive Surgery
2019;41(1):14-
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: Condylar dislocation can arise as a complication in patients who required mandibular and/or condylar reconstruction and were operated on with fibula free flap (FFF) using surgical guides designed using simulation surgery. Surgeons should be aware of the complications in these present cases when planning and performing reconstructions as well as predicting prognoses. CASES PRESENTATION: Two cases showed condylar dislocation in mandibular reconstruction using a FFF fixed with a reconstruction plate. Three cases showed condylar dislocation in mandibular reconstruction using a fibula free flap fixed with a mini-plate. CONCLUSION: Despite the lack of clinical symptoms in these cases following mandibular reconstruction using an FFF, the mandibular condyle was severely displaced away from the glenoid fossa. A surgeon must have sufficient time to consider the use of a long flap with thickness similar to that of the mandible, ways to minimize span and bending, and methods of fixation. The patient, moreover, should be educated on condylar dislocation. Customized CAD/CAM-prototyped temporomandibular condyle-connected plates may be a good alternative even if virtual simulation surgery is to be performed before surgery. These considerations may help reduce the incidence of complications after mandibular reconstruction.
