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Peer-reviewedCC BY-NC-NDActa otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale

Review of fixation techniques in double-barrel fibula flap and introduction of a new technique.

  • Resi Pucci1
  • Carola Grazia Corbetta1,2
  • Michele Di Cosola3
  • Vincenzo Antonio Marcelli1
  • Flavio Andrea Govoni1
  • Nicola Felici4
  • Roberto Pistilli1
4 affiliations
  1. 1Department of Head and Neck, San Camillo-Forlanini Hospital, Rome, Italy.
  2. 2Department of Oral and Maxillofacial Sciences, La Sapienza University of Rome, Rome, Italy.
  3. 3Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy.
  4. 4Unit of Plastic, Reconstructive and Hand Surgery, San Camillo-Forlanini Hospital, Rome, Italy.
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Abstract

Objective

The fibula flap is the preferred choice for mandibular reconstruction, especially with recent technological advancements. This study presents and evaluates a novel EASY-WEAR-OFF CAD/CAM patient-specific implant (PSI) double-barrel double-plate designed to improve stabilisation and outcomes.Methods

A custom CAD/CAM plate with 2 parts, a long-bar and a short-bar plate, connected by vertical rods, was developed. Implant placement was performed under local anaesthesia alongside the removal of the short-bar plate at 6 months postoperatively. Literature on fixation techniques and CAD/CAM designs was reviewed to contextualise this approach.Results

The double-barrel technique provides greater vertical bone height than the single-bar, reducing the bone gap and improving implant conditions. This PSI shows potential for better patient satisfaction and functional outcomes, supporting easier implant placement and postoperative management.Conclusions

This CAD/CAM PSI may enhance mandibular reconstruction using the double-barrel fibula flap. Further studies with larger cohorts are needed to confirm its clinical benefits and long-term outcomes.

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Cite

BibTeXRIS
BibTeX
@article{pucci2026review,
  title = {{Review of fixation techniques in double-barrel fibula flap and introduction of a new technique.}},
  author = {Resi Pucci and Carola Grazia Corbetta and Michele Di Cosola and Vincenzo Antonio Marcelli and Flavio Andrea Govoni and Nicola Felici and Roberto Pistilli},
  journal = {Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale},
  year = {2026},
  month = oct,
  doi = {10.14639/0392-100x-a1723},
  url = {https://europepmc.org/article/MED/42969780},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Review of fixation techniques in double-barrel fibula flap and introduction of a new technique.
AU  - Resi Pucci
AU  - Carola Grazia Corbetta
AU  - Michele Di Cosola
AU  - Vincenzo Antonio Marcelli
AU  - Flavio Andrea Govoni
AU  - Nicola Felici
AU  - Roberto Pistilli
PY  - 2026
DA  - 2026/10/01
JO  - Acta otorhinolaryngologica Italica : organo ufficiale della Societa italiana di otorinolaringologia e chirurgia cervico-facciale
DO  - 10.14639/0392-100x-a1723
UR  - https://europepmc.org/article/MED/42969780
AB  - Objective  The fibula flap is the preferred choice for mandibular reconstruction, especially with recent technological advancements. This study presents and evaluates a novel EASY-WEAR-OFF CAD/CAM patient-specific implant (PSI) double-barrel double-plate designed to improve stabilisation and outcomes.Methods  A custom CAD/CAM plate with 2 parts, a long-bar and a short-bar plate, connected by vertical rods, was developed. Implant placement was performed under local anaesthesia alongside the removal of the short-bar plate at 6 months postoperatively. Literature on fixation techniques and CAD/CAM designs was reviewed to contextualise this approach.Results  The double-barrel technique provides greater vertical bone height than the single-bar, reducing the bone gap and improving implant conditions. This PSI shows potential for better patient satisfaction and functional outcomes, supporting easier implant placement and postoperative management.Conclusions  This CAD/CAM PSI may enhance mandibular reconstruction using the double-barrel fibula flap. Further studies with larger cohorts are needed to confirm its clinical benefits and long-term outcomes.
SN  - 0392-100X
SN  - 1827-675X
ER  -