Immediate mandibular reconstruction of a u.s. navy seal with a free fibula flap following osteoradionecrosis with pathological fracture

作     者：Ferguson, B Caballero, H. Cole, S. Hatt, H. Bach, K. Douglas, T. Gallus, K. Laughlin, R. 

作者机构：Dental Department Naval Medical Center Suit 206 34800 BobWilson Dr San Diego CA 92134 U.S.A. 

出 版 物：《中国口腔颌面外科杂志》 (China Journal of Oral and Maxillofacial Surgery)

年 卷 期：2008年第6卷第B5期

页      面：218-219页

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 10[医学] 

主　　题：颚 修复方法 整形技术 腓骨 放射性骨坏死 

摘      要：The number of U。S。Navy SEALs that serve within U。S。Special Operations Command (SOCOM) is fewer than 2,500; this is an extremely small number when compared to the 1.5 million total U。S。military personnel currently serving on active duty。When a highly-trained highly-specialized service person is injured or medically incapacitated, it is extremely important to return him to an operational status as soon as possible。Due to the physical requirements of these personnel, reconstruction options can be limited。We present a U。S。Navy SEAL who was diagnosed with osteoradionecrosis (ORN) and a pathologic fracture of the mandible。The gamet of reconstruction options were considered。A flee fibular flap for mandibular reconstruction allowed the surgical team to complete a one-stage reconstruction with minimized functional disability, which permitted the patient a fully operational return to the SOCOM community。Case report: A 41yo male active duty Navy personnel with a history of squamous cell cancer of the base of tongue (T1N2bM0) was diagnosed with ORN。Initial treatment consisted of the Marx-University of Miami Protocol for Hyperbaric oxygen therapy。He responded with complete soft tissue coverage of the exposed bone to the right mandible。One month later, the patient, returned to the Otolaryngology Department with recurrence of exposed bone to the right mandible。He was referred to the Oral and Maxillofacial Surgery clinic at Navy Medical Center San Diego for evaluation and treatment。Surgical debridement of right mandible to bleeding bone leaving an intact inferior border was performed。