Prosthetically Guided Reconstruction of Maxilla with Free Fibular Flap as a Secondary Reconstruction in Maxillary Defects Caused by Mucormycosis.

Introduction: Rhinocerebral mucormycosis (RCM) is devastating disease causing local morbidity as well mortality in some individuals. Many patients have lost their one side or bilateral maxilla and zygomatic bone. Patients survive with such facial deformity and become social cripple. We are proposing technique where existing denture is used as a template and also as temporary prosthesis for plating the fibula in best prosthetical position. Patients and methods: Thirty patients were included in the study those fit inclusion criteria. All of them underwent unilateral or bilateral maxillary reconstruction by free microvascular fibular flap for bony as well soft tissue reconstruction. Eight patients have unilateral defect, and 22 had bilateral defects. Results: Out of 30, 1 patient had flap failure due to venous congestion, in all 29 patients flap was well taken. In that patient, we did salvage fibular flap from other lower limb and that was well taken. Other than minor local infection and hyper-granulation tissue formation in oral cavity, we did not have any major complications. Conclusion: This provides best opportunity for prosthetic as well cosmetic rehabilitation. For young and fit patients, this is the best reconstruction option. This approach gives best opportunity for both hard and soft tissue reconstruction and simultaneous dental rehabilitation.