Quantifying Free Fibula Flap Growth After Pediatric Mandibular Reconstruction

Summary

The purpose of this report is to quantify mandibular growth in a young patient undergoing partial hemi-mandibular reconstruction with a free fibula flap (FFF) utilizing advanced three-dimensional software. A 2-year old underwent left hemi-mandibular reconstruction with a FFF following resection of a desmoid tumor. The condyle was preserved. Using 3D software, changes in mandibular growth and morphology were evaluated based on preoperative (2.1 years old) and postoperative (2.5 years and 5.2 years old) computed tomography imaging. Mandibular growth occurred throughout the mandible in both postoperative evaluations. Providing an objective evaluation using 3D software, we have demonstrated growth throughout the reconstructed mandible, with greatest growth occurring at the preserved condyle. Despite scientific limitations of our study, the potential for mandibular growth appears to remain after FFF reconstruction, offering successful functional and cosmetic outcomes.