Universidad Peruana Cayetano Heredia

Long-term facial symmetry after pediatric mandibular reconstruction using the vascularized fibula free flap: A photogrammetric analysis.

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dc.contributor.author Zavala, Abraham
dc.contributor.author Ore, Juan F.
dc.contributor.author Rizo-Patron, Emiliana
dc.contributor.author De Pawlikowski, Wieslawa
dc.date.accessioned 2022-11-15T23:04:40Z
dc.date.available 2022-11-15T23:04:40Z
dc.date.issued 2022
dc.identifier.uri https://hdl.handle.net/20.500.12866/12572
dc.description.abstract BACKGROUND: The fibula free flap is the standard of care in the reconstruction of large mandibular defects in pediatric patients, enabling adequate restoration of the facial contour. However, the unpredictable growth potential of the reconstructed mandible could influence the preservation of the initially restored symmetry over time. Being mindful of the importance of facial appearance during developmental stages, this study aimed to evaluate the long-term facial symmetry after mandible reconstruction using this technique in growing patients.PATIENTS AND METHODS: A photogrammetric analysis of facial symmetry using the "Asymmetry Index" (AI) was performed from preoperative and postoperative frontal photographs in 17 pediatric patients (9 males and 8 females) who underwent mandibular reconstruction with the vascularized fibula free flap and had a minimum follow-up of 5 years. Comparisons between preoperative and postoperative measurements-as well as postoperative comparisons between condyle-reconstructed and condyle-preserved patients-were conducted.RESULTS: The mean follow-up was 76.9 (± 19.0) months (range, 60-120). The average age at intervention was 9.23 (± 3.8) years. Mean AI was 15.31 (± 1.81) preoperatively and 3.59 (± 0.97) postoperatively. Differences between preoperative and postoperative measurements were statistically significant in all the assessed parameters (p<0.001). Postoperative differences between the condyle-reconstructed and the condyle-preserved groups were not significant (p>0.05). No secondary procedures were required to enhance symmetry in the late postoperative period.CONCLUSIONS: Mandibular reconstruction using the vascularized fibula free flap provides adequate restoration of facial symmetry that could be predictably maintained throughout the developmental period in children and adolescents, regardless of the need for condylar reconstruction. en_US
dc.language.iso eng
dc.publisher Elsevier
dc.relation.ispartofseries Journal of Plastic, Reconstructive and Aesthetic Surgery
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Facial symmetry en_US
dc.subject Mandible reconstruction en_US
dc.subject Pediatric reconstruction en_US
dc.subject Fibula free flap en_US
dc.subject Microsurgery en_US
dc.title Long-term facial symmetry after pediatric mandibular reconstruction using the vascularized fibula free flap: A photogrammetric analysis. en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1016/j.bjps.2022.06.085
dc.relation.issn 1878-0539


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