CASE REPORT article
Front. Oncol.
Sec. Head and Neck Cancer
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1678310
Case Report: Free Fibula Flap for Post-Oncologic Mandibular Reconstruction, First Experience in Tirana
Provisionally accepted
- 1Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
- 2Maxillofacial Surgery Unit, University Hospital Center Mother Theresa, Tirana, Albania
- 3Private Practice Maxillofacial Surgeon, Tirana, Albania
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Mandibular reconstruction using an osteocutaneous free fibular flap is a highly advanced microsurgical procedure, rarely performed in developing healthcare systems due to technical complexity and infrastructure demands. We present the first successful case performed in Tirana, Albania, demonstrating the feasibility of implementing such techniques in emerging surgical settings. A 54-year-old male diagnosed with squamous cell carcinoma of the left mandibular alveolar crest (cT4N1M0) underwent left hemimandibulectomy, bilateral neck dissection and immediate mandibular reconstruction using a right osteocutaneous fibular free flap. Preoperative Doppler ultrasonography confirmed sufficient vascular supply, excluding contraindications such as peripheral vascular disease and venous insufficiency. Fibula was harvested without tourniquet, improving vascular visualization and reducing ischemic time. A 4 × 7 cm skin paddle was included for intraoral soft tissue reconstruction. Cervical recipient vessels were isolated for microvascular anastomosis. Postoperative management involved intensive monitoring by a multidisciplinary team. Flap viability was assessed through color, temperature, capillary refill, and Doppler signals, with early mobilization and speech/swallowing therapy initiated promptly. The patient experienced an uneventful recovery with complete flap survival and functional restoration. This case highlights the potential to achieve complex microvascular reconstructions successfully in resource-limited environments through careful planning and interdisciplinary collaboration.
Keywords: Oral squamous cell carcinoma (OSCC), Fibula free flap, Mandibular reconstruciton, oncologic reconstruction, developing health care systems, Microsurgery
Received: 02 Aug 2025; Accepted: 05 Sep 2025.
Copyright: © 2025 Marzi Manfroni, Sako, Mataj, Zhupa and Laganà. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Alice Marzi Manfroni, Maxillofacial Surgery Unit, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.