Indications and contraindications

Authors: Mette Hørberg, consultant in oral and maxillofacial surgery, Frederik Gulmark Hansen, med.stud., Magnus Balslev Avnstorp MD and Jytte Buhl, consultant in oral and maxillofacial surgery

Indications for surgery

Indications for mandibular reconstruction are versatile, and include oncological resections, oral mucosa squamous cell carcinoma involving the mandibular bone, osteosarcoma of the jaws, traumatic injuries, or other pathological, developmental, or congenital disorders and osteoradionecrosis following radiation treatment. The intention of the reconstruction is to restore the complex anatomy with maximum possible functionality and high accuracy. Thorough evaluation of the facial wound, including radiographic assessment preferably with three-dimensional CT scans, will delineate the extent of the missing tissue.

Contraindications for surgery

Severely ill patient/ Co-morbidity status

No curative possibilities by surgery

CT angiogram of lower limbs showing either significant peripheral vascular atherosclerotic disease affecting the lower limb vessels or less than three-vessel supply to the foot. The presence of a Peronea Magna is an absolute contraindication for a fibula free flap harvest.