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Fibular osteocutaneous free flap reconstruction of the mandible after resection of ossifying fibroma in a seven-year old child
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Abstract
Ossifying fibromas (OSF) belong to a group of benign fibro-osseous neoplasms encountered almost exclusively in the craniofacial skeleton. The clinical course is typically asymptomatic. However, discomfort in the mouth begins to develop once the neoplasm progressively extends, causing an overgrowth of bone resulting in pain and facial asymmetry. The development of craniofacial bone tumors in children is quite a rare occurrence. In international medical literature, the described cases typically involve young adolescent patients, with very few case reports of craniofacial neoplasms in children under the age of seven [1, 2]. In the current case report, we present a seven-year-old patient with a biopsy-proven ossifying fibroma. The patient underwent a resection of the neoplasm with reconstruction. One of the major issues encountered in reconstruction of the mandible using a vascularized fibular flap in children is the growth potential of the fibula in comparison to the mandible, resulting in a symmetrical facial image. The use of a fibular osteocutaneous free flap in reconstruction of mandibular deficits in children is a favourable solution. The use of this type of flap permits functional restoration and significantly improved facial cosmesis. The union of the mandible with the integrated fibula is still a topic of ongoing discussion and one must be prepared for possible further orthognathic procedures after completing the growth of the craniofacial skeleton.
Abstract
Ossifying fibromas (OSF) belong to a group of benign fibro-osseous neoplasms encountered almost exclusively in the craniofacial skeleton. The clinical course is typically asymptomatic. However, discomfort in the mouth begins to develop once the neoplasm progressively extends, causing an overgrowth of bone resulting in pain and facial asymmetry. The development of craniofacial bone tumors in children is quite a rare occurrence. In international medical literature, the described cases typically involve young adolescent patients, with very few case reports of craniofacial neoplasms in children under the age of seven [1, 2]. In the current case report, we present a seven-year-old patient with a biopsy-proven ossifying fibroma. The patient underwent a resection of the neoplasm with reconstruction. One of the major issues encountered in reconstruction of the mandible using a vascularized fibular flap in children is the growth potential of the fibula in comparison to the mandible, resulting in a symmetrical facial image. The use of a fibular osteocutaneous free flap in reconstruction of mandibular deficits in children is a favourable solution. The use of this type of flap permits functional restoration and significantly improved facial cosmesis. The union of the mandible with the integrated fibula is still a topic of ongoing discussion and one must be prepared for possible further orthognathic procedures after completing the growth of the craniofacial skeleton.
Keywords
ossifying fibroma, fibular flap, mandible, microvascular anastomosis, fibula
About this articleTitle
Fibular osteocutaneous free flap reconstruction of the mandible after resection of ossifying fibroma in a seven-year old child
Journal
Nowotwory. Journal of Oncology
Issue
Pages
54-58
Published online
2017-08-24
Page views
730
Article views/downloads
1007
DOI
Bibliographic record
Nowotwory. Journal of Oncology 2017;67(1):54-58.
Keywords
ossifying fibroma
fibular flap
mandible
microvascular anastomosis
fibula
Authors
Bartosz Mańkowski
Joanna Bilska-Stokłosa
Krzysztof Osmola
Marian Nowaczyk
Tadeusz Półchłopek