Modern Mandible Reconstruction Utilizing the Chimeric Fibula Free Flap and Double-Barreling Techniques.

Introduction The fibula osteocutaneous flap is now commonly used to reconstruct composite mandibular defects. Difficulties in flap execution are invariably related to the dynamic relationship of the bone orientation and the skin paddle inset. Traditional design has been limited to a single-strut bony design in order to restore mandibular continuity, without restoration of mandibular height and contour. Full chimeric design of the fibula allows for the routine use of a double barrel strut to optimize functional and aesthetic outcomes. The purpose of this study was to critically evaluate these techniques during reconstruction of composite mandibular defects.