The sensate fibula osteoseptocutaneous flap: a preliminary report

The ideal oromandibular reconstruction calls for restoration of intraoral sensation as well as tissue replacement because the loss of sensation in the oral cavity impairs oral function. The versatility and flexibility of the fibula osteoseptocutaneous flap in complex three dimensional spatial positioning lends itself to be desirable in composite oromandibular reconstruction. It falls short of being ideal because the skin paddle of the flap is usually insensate and thus oral sensation is not restored. The skin paddle of the fibula osteoseptocutaneous flap is innervated by the lateral sural cutaneous nerve and this nerve can be preserved and reinnervated to restore sensation to the skin paddle. The sensate fibula osteoseptocutaneous flap may be the ideal flap for one stage composite reconstruction of oromandibular defects. This is a preliminary report on the sensory return of the sensate fibula osteoseptocutaneous flap in oromandibular reconstruction.