Immediate mandibular reconstruction with microsurgical fibula flap transfer following wide resection for ameloblastoma

Ameloblastoma, the most common odontogenic tumor, is a slow growing, localized tumor of the facial skeleton. Eighty percent of the tumors affect the mandible. Treatment by wide excision is curative in 95% of cases. Reconstruction by bone grafting has a 20% to 30% nonunion rate. We have treated three large ameloblastomae (>6 cm) with fibula flaps, following resection. All patients have healed. With follow-up times of 2 to 3 years, there has been no evidence of recurrence and no difficulties with postoperative evaluation for recurrent disease. We conclude that the fibula flap is a reliable reconstructive operation following resection of large ameloblastomae.