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      Neoformación condilar posterior a una reconstrucción mandibular con colgajo libre microvascularizado de peroné: un informe de caso Translated title: Condylar neoformation after mandibular reconstruction with microvascularized fibula free flap: a case report

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          Abstract

          RESUMEN El colgajo microvascularizado de peroné es el estándar de oro para la reconstrucción mandibular por su gran capacidad de remodelación ósea; se ha evidenciado que el segmento distal del peroné puede tomar la forma y estructura de un cóndilo. Se reporta el caso clínico de un paciente adulto de sexo masculino diagnosticado con mixoma odontogénico, quien fue intervenido quirúrgicamente a través de una hemimandibulectomía con resección total del cóndilo y una reconstrucción mandibular primaria mediante un colgajo libre microvascularizado de peroné. Después de 30 meses de seguimiento se observó una neoformación condilar y adaptación progresiva a la cavidad glenoidea, a pesar de que el extremo distal del peroné se encontró originalmente alejado de la posición planificada de manera digital.

          Translated abstract

          ABSTRACT The microvascularized fibula flap is the gold standard for mandibular reconstruction due to its great capacity for bone remodelling, it has been shown that the distal segment of the fibula can take on the shape and structure of a condyle. We report the clinical case of an adult male patient diagnosed with odontogenic myxoma, who was underwent hemimandibulectomy with total resection of the condyle and primary mandibular reconstruction using a microvascularized free flap of the fibula. After 30 months of follow-up, condylar neoformation and progressive adaptation to the glenoid cavity was observed even though the distal end of the fibula was originally distant from the digitally planned position.

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          Most cited references20

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          Improved mandible function after hemimandibulectomy, condylar head preservation, and vascularized fibular reconstruction.

          Temporomandibular joint dysfunction after tumor extirpation of the hemimandible is a frequent sequela after condylar head reconstruction. Condylar head resection is often performed because of oncological and vascular considerations. Recent studies have demonstrated that malignancies of the mandibular ramus and body rarely involve the condylar head, and that the vascularity and supportive structures of the condylar head are sufficient to maintain viability and function. This study demonstrates that temporomandibular joint function is preserved after hemimandibulectomy without resection of the condylar head. Fixation of a vascularized fibular flap to the condylar head is performed in situ. Condylar viability and growth is maintained with painless incisal opening. The condylar head is a growth center for the mandible in the pediatric population. Its preservation in these patients will avoid the long-term problems associated with growth center loss such as malocclusion and concomitant maxillary deformity.
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            Long-term radiological findings following reconstruction of the condyle with fibular free flaps.

            Fibular bone grafts are considered as one of the best choices for reconstruction of the condyle. However, little data are available on bone remodelling after such reconstruction. The purpose of this study was to evaluate the long-term radiological outcome.
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              Association between condylar position changes and functional outcomes after condylar reconstruction by free fibular flap.

              Stable and appropriate condyle positioning is necessary for maintaining temporomandibular joint function. It is unclear if this position remains stable in patients after free fibular flap (FFF) condylar reconstruction. We investigated whether condylar position deviated after reconstruction, and whether this affected functional recovery.
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                Author and article information

                Journal
                maxi
                Revista Española de Cirugía Oral y Maxilofacial
                Rev Esp Cirug Oral y Maxilofac
                Sociedad Española de Cirugía Oral y Maxilofacial y de Cabeza y Cuello (Madrid, Madrid, Spain )
                1130-0558
                2173-9161
                December 2022
                : 44
                : 4
                : 160-166
                Affiliations
                [1] Quito Quito orgnameUniversidad Central del Ecuador orgdiv1Hospital General Docente de Calderón Ecuador
                Article
                S1130-05582022000400006 S1130-0558(22)04400400006
                10.20986/recom.2023.1416/2022
                6ae86f95-53bb-4003-bd17-fd15f13cf2b1

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 20 December 2022
                : 07 February 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 21, Pages: 7
                Product

                SciELO Spain

                Categories
                Casos Clínicos

                free tissue flaps,informe de caso clínico,cóndilo mandibular,colgajos de tejido libre,Reconstrucción mandibular,case report,mandibular condyle,Mandibular reconstruction

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