Microvascular reconstruction of mandibular defects in paediatric patients

Background: During mandibular reconstruction in paediatric patients special consideration must be given to the issues related to growth when restoration of the mandibular and maxillary relationship is essential for correct development of the facial skeleton, a dynamic process whereby mandibular and maxillary growth are strongly correlated. Wide resections, irradiated fields, infection at the recipient site, and scars are strong indications for using revascularized bone-containing free flaps. Methods: Five patients were reviewed, with a follow-up ranging from 5 to 11 years. Measurements were performed on frontal and lateral views to assess mandibular angle symmetry, midline deviation and facial angle. Measurements were also made on orthopantomograms to assess differences in growth between the normal and reconstructed sides. Results: Optimal functional and aesthetic results were obtained. Conclusions: The data suggest that the reconstructed mandible undergoes growth, and that even if this process is unpredictable, it can be sufficient to allow appropriate development of the face. © 2010 European Association for Cranio-Maxillo-Facial Surgery.