CC BY-NC-ND 4.0 · Indian J Plast Surg 2009; 42(02): 252-254
DOI: 10.1055/s-0039-1699356
Case Report
Association of Plastic Surgeons of India

Vascularised fibula osteocutaneous flap for cervical spinal and posterior pharyngeal wall reconstruction

Krishnakumar Thankappan
Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Elamakkara, Kochi, India
,
Sandip Duarah
Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Elamakkara, Kochi, India
,
Nirav P. Trivedi
Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Elamakkara, Kochi, India
,
Dilip Panikar
1  Neurosurgery, Amrita Institute of Medical Sciences, Elamakkara, Kochi, India
,
Moni Abraham Kuriakose
Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Elamakkara, Kochi, India
,
Subramania Iyer
Department of Head and Neck Surgery, Amrita Institute of Medical Sciences, Elamakkara, Kochi, India
› Author Affiliations
Further Information

Publication History

Publication Date:
15 January 2020 (online)

ABSTRACT

We report a case of vascularised fibula osteocutaneous flap used for composite cervical spinal and posterior pharyngeal wall reconstruction, in a patient with recurrent skull base chordoma, resected by an anterior approach via median labio-mandibular glossotomy approach. Bone stability and pharyngeal wall integrity were simultaneously restored

 
  • REFERENCES

  • 1 Lanzino G, Dumont AS, Lopes MB, Laws ER Jr. Skull base chordomas: Overview of disease, management options, and outcome. Neurosurg Focus 2001;10:E12.
  • 2 Frank G, Sciarretta V, Calbucci F, Farneti G, Mazzatenta D, Pasquini E. The endoscopic transnasal transsphenoidal approach for the treatment of cranial base chordomas and chondrosarcomas. Neurosurgery 2006;59:ONS50-7
  • 3 Hassan S, Abdullah JM, Wan Din SJ, Idris Z. Combined use of maxillomandibular swing approach and neurosurgical ultrasonic aspirator in the management of extensive clival chordoma: a case report. J Med Case Reports 2008;2:49
  • 4 Bernard TN Jr, Whitecloud TS 3rd. Cervical spondylotic myelopathy and myeloradiculopathy: Anterior decompression and stabilization with autogenous fibula strut graft. Clin Orthop Relat Res 1987;221:149-60.
  • 5 Macdonald RL, Fehlings MG, Tator CH, Lozano A, Fleming JR, Gentili F, et al. Multilevel anterior cervical corpectomy and fibular allograft fusion for cervical myelopathy. J Neurosurg 1997;86:990-7.
  • 6 Gross TP, Jinnah RH, Clarke HJ, Cox QG. The biology of bone grafting. Orthopedics 1991;14:563-8.
  • 7 Burchardt H. Biology of bone transplantation. Orthop Clin North Am 1987;18:187-96.
  • 8 Rossier AB, Hussey RW, Kenzora JE. Anterior fibular interbody fusion in the treatment of cervical spinal cord injuries. Surg Neurol 1977;7:55-60.
  • 9 Bradford DS. Anterior vascular pedicle bone grafting for the treatment of kyphosis. Spine (Phila Pa 1976) 1980;5:318-23.
  • 10 Rose GK, Owen R, Sanderson JM. Transposition of rib with blood supply for the stabilisation of a spinal kyphos. J Bone Joint Surg (Br) 1975; 57:112.
  • 11 Wittenberg RH, Moeller J, Shea M, White AA 3rd, Hayes WC. Compressive strength of autologous and allogenous bone grafts for thoracolumbar and cervical spine fusion. Spine (Phila Pa 1976) 1990;15:1073-8.
  • 12 Smith MD, Cody DD. Load-bearing capacity of corticocancellous bone grafts in the spine. J Bone Joint Surg Am 1993;75:1206-13.
  • 13 Wright NM, Kaufman BA, Haughey BH, Lauryssen C. Complex cervical spine neoplastic disease: Reconstruction after surgery by using a vascularised fibular strut graft. J Neurosurg 1999;90: 133-7.
  • 14 Freidberg SR, Gumley GJ, Pfeifer BA, Hybels RL. Vascularised fibular graft to replace resected cervical vertebral bodies. Case report. J Neurosurg 1989;71:283-6.
  • 15 Nemoto K, Asazuma T, Amako M, Kawaguchi M, Yamagishi M, Mizuno H. Vascularised fibula graft for spinal fusion in severe cervical kyphosis due to neurofibromatosis. J Reconstr Microsurg 1997;13:559-62.
  • 16 Erdmann D, Meade RA, Lins RE, McCann RL, Richardson WJ, Levin LS. Use of the microvascular free fibula transfer as a salvage reconstruction for failed anterior spine surgery due to chronic osteomyelitis. Plast Reconstr Surg 2006;117:2438-45
  • 17 Ng RL, Beahm E, Clayman GL, Hassenbusch SJ, Miller MJ. Simultaneous reconstruction of the posterior pharyngeal wall and cervical spine with a free vascularised fibula osteocutaneous flap. Plast Reconstr Surg 2002;109:1361-5.
  • 18 Winters HA, van Engeland AE, Jiya TU, van Royen BJ. The use of free vascularised bone grafts in spinal reconstruction. J Plast Reconstr Aesthet Surg doi:10.1016/j.bjps.2008.11.037
  • 19 Krishnan KG, Müller A. Ventral cervical fusion at multiple levels using free vascularised double-islanded fibula - a technical report and review of the relevant literature. Eur Spine J 2002;11:176-82.