Medical Case Reports

Biography

Biography: Narjiss Akerzoul

Abstract

Introduction: The ameloblastoma is a rare odontogenic tumor of the oral cavity. It affects more the mandible than the maxilla and has a predilection for the posterior region. Although this tumor is benign, its behavior is locally aggressive and requires the most often surgical resection margin. Clinical Observation: A young woman aged 28 has consulted the service of Surgical Dentistry of Rabat, complaining of right mandibular swelling lasting for eight months. Panoramic radiography revealed the presence of a multi-geodic picture at the right hemi-mandible. A biopsy was performed at the level of the lesion and entered the presence of aameloblastoma. The patient was subsequently sent to the Maxillofacial Surgery Service of the Hospital of Specialties of Rabat. Two teams, one of maxillofacial surgery and other vascular surgery collaborated to produce a hemi-mandibulectomy poses with a graft of the fibula. Discussion: The indication of radical or conservative treatment should be guided by the anatomical location of the lesion, the radiological aspect and especially macroscopic intraoperative. Conservative treatment is carried out for non extensive lesions with the assurance of a future clinical monitoring. Bone resection with or without immediate reconstruction is needed in extended forms breaking cortical bone, the periosteum and soft tissue invasiveness. The free fibula flap was the preferred graft for oromandibular reconstruction because of its versatility and the consistency in the size of the fibula bone and stability. The free fibula flap allows skin palette to be obtained that is up to 25 cm long and 5 cm wide. The fibula periosteal vascularization and thus can withstand multiple osteotomies without compromising significantly, when the periosteum is left set. The free graft of the fibula can be considered a reliable graft with low morbidity and also adapted for future dental rehabilitation.