We present the harvest of a osteocutaneous fibula free flap for head and neck reconstruction performed at the University of Cincinnati. This reconstructive technique has a wide variety of implications but has found greatest utility in the reconstruction of mandibular defects.
Osteocutaneous fibula free flap harvest
Mandibular reconstruction
Contraindications for the harvest of this flap may include peripheral vascular disease of lower extremity, lower extremity vascular anomalies, history of trauma/fractures of the fibula bone.
Microvascular flap harvest set, doppler, tourniquet, bone saw, dermatome, craniomaxillofacial instruments. Suture material for closure per surgeon preference.
This video shows a transotic approach for a cochlear schwannoma in a 59-year-old female who presented with sudden sensorineural hearing loss in her left three years prior. She was found to have subsequent growth of her tumor on imaging and elected to undergo surgery. The transotic approach is a valuable approach within the armamentarium of a skull base team and differs from the transcochlear approach in the handling of the facial nerve. Techniques for ear canal overclosure, eustachian tube packing and mastoid obliteration are also highlighted.
Review Fibula Free Flap Harvest.