Combined reconstruction of the mandible in children using a customized endoprosthesis with a temporomandibular joint implant and fibula free ftap reconstruction

Although surgical removal of head and neck tumors remains a relevant method of local control in pediatric patients, it can lead to the formation of extensive, complex maxillofacial defects. There is no doubt that restoration of anatomical integrity and function of the mandible in children is necessary in the majority of cases, however the choice of reconstruction method is still controversial. In this article, we present a method of combined mandibular reconstruction in children involving the use of a customized endoprosthesis with a temporomandibular joint implant and microsurgical reconstruction with a fibula free flap, which provides optimal functional and aesthetical results and enables patients to receive complete dental rehabilitation in the future (including the placement of permanent dental implants), and report a case series demonstrating this method. The study was approved by the Independent Ethics Committee and the Scientific Council of the Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology of Ministry of Healthcare of the Russian Federation. The patients' parents gave their consent to the use of their child's data, including photographs, for research purposes and in publications.