Infrazygomatico-coronoid fixation in a segmental mandibular reconstruction with a free vascularized flap: A simple and correct repositioning method without interfering with reconstructive and microsurgical procedures.

Abstract

In a segmental mandibular reconstruction with a free vascularized flap, reproducing the optimal relationship between the condyle and glenoid fossa, and maintaining correct occlusion are important. We examined the practicality of a repositioning technique that combined bone plate fixation of the infrazygomatic crest and the coronoid process (infrazygomatico-coronoid fixation [IZCF]) with maxillo-mandibular fixation (MMF). Eight patients were treated with this method. To investigate masticatory function, the status of the dental and temporomandibular joints were examined, and a food scale questionnaire was administered. IZCF and MMF resulted in correct repositioning of the segmented mandibles and enabled accurate reconstructions. Most patients recovered to be able to ingest the same preoperative food in scale with stable occlusion. This method is a simple and correct repositioning method without interfering with reconstructive and microsurgical procedures. We propose this technique as a reliable method for obtaining a functional outcome in mandibular reconstruction. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1708-1716, 2016.