Nguyen HongNhung (Rosy)

University degrees: Doctor of Medicine, I.M.Sechenov Moscow Medical Academy, 2010. Diploma of Plastic surgery, Hanoi Medical University, 2011. PhD of Maxilofacial and Plastic Surgery, Institute of Clinical Medical Science 108, Vietnam, 2022. Thesis: “Research of using free lateral arm flap in soft tissue reconstruction after oral cancer rejection”. Other experiences:

2011: Fellow of Plastic and Reconstructive Surgery Training, Hanoi. 2014: Fellow of Microsurgery Training course, Central Military Hospital 108. 2015: Participated in the 5th Intensive Microsurgery Training course lectures and hands on, Hospital Kuala Lumpur. List membership of professional organizations: Vietnam Association of Stomatologist and Maxillo-Facial Surgeons; Vietnam Association of Surgery, Operation Smile Vietnam; The Hanoi Association of Plastic and Aesthetic Surgery; The Vietnamese Society of Aesthetic Plastic Surgery.

Research areas: Aesthetic laser and surgery, Conventional Plastic and Reconstructive Surgery: Cleft lip and Cleft palate repair, Maxillary reconstruction, Reconstructive Microsurgery: Mandibular Reconstruction, Maxillofacial Reconstruction, Aesthetic surgery: Blepharoplasty, Rhinoplasty, Breast Augmentation.

Title: Evaluation of Initial Result of 3D Application in Mandibular Reconstruction by Free Fibula Flap

Microsurgery is a highly complex technique that requires specialized equipment and steady surgical techniques. This is a retrospective review of the development progress of microsurgical techniques at Hanoi National Hospital of Odonto-Stomatology (NHOS) during the past 12 years. Methods: Retrospective study assessing the training and developing process of microsurgical techniques at NHOS in 12 years. Results: NHOS has performed 665 microsurgical flaps reconstructions after surgical removal of large tumors in maxillomandibular area. 441 fibular free flaps were harvested for mandibular reconstructions after resections of ameloblastoma and osteofibroma. 4 fibular flaps were used for maxillary reconstructions. 119 osteocutaneous fibular free flaps were harvested for mandibular reconstructions in oral cancer surgeries. 83 lateral arm flaps and 13 anterolateral thigh flaps reconstructions were performed following cancer ablations. 5 patients underwent reconstruction after cancer resection with 2 fibular free flaps and anterolateral thigh flaps. Success rate is 654/665 (98.35%). Conclusion: The implementation of microsurgery technique at NHOS has been carried out for only 12 years but rapid and significant progress has been made. Free flap reconstruction is a flexible reconstructive option to restore essential functions and aesthetics of the facial area and to improve the patient’s quality of life.

Hanoi National Hospital of Odonto-Stomatology (NHOS) is a large facility specializing in Odonto- Stomatology and Oral surgery. Reconstructive intervention after surgical removal of diseased area is very important. The resection of large benign tumors or malignant tumors always leaves big defects that cannot be repaired with conventional reconstructive techniques.

The advent of microsurgery has encouraged surgeons to use free flaps to overcome the challenges faced by reconstructive surgery using conventional techniques. Microsurgical techniques were originally developed since the 1970s of the last century. In the 1980s, Dr. Nguyen Huy Phan developed microsurgical techniques in Vietnam. The first microsurgeries were performed at 108 Military Central Hospital. The NHOS took initiatives to perform the first microsurgeries in 2008.

In this review, we report the progress of surgical approach, training and development of microsurgery at NHOS in the period from 2008 to 2020. We access the number of performed microsurgeries, types of free flaps, pathological conditions that require microsurgery, complications and surgical outcomes, as well as the success rate after surgery.

Oral cancer is the 6th most common malignancy worldwide. In Vietnam, afflicted patients often visit hospitals for diagnostic and treatment with advanced-stage and large tumors. Oral cancer does not respond well to radiation or chemotherapy, so extensive tumor resection and cervical lymphadenectomy are the best treatment options. Wide surgical excisions of tumor often leave major maxillomandibular defects such as mandibular-oral floor defect, oral floor defect, partial or total tongue defect, tongue-oral floor defect, cheek mucosa defect, orofacial fistula. The reconstruction of these defects requires careful selection of suitable free flaps. We have harvested 119 osteocutaneous fibular free flaps to reconstruct the mandibular and to cover the oral floor; 83 lateral arm flaps for reconstructions of tongue, oral floor, buccal mucosa; 13 anterolateral thigh flaps to reconstruct major soft-tissue defects and to cover orofacial fistulas. The combination of both fibular flap and anterolateral thigh flaps is used in 5 cases to reconstruct mandible-oral floor and to cover the area after tumor resection.

Reconstructive surgery following the resection of maxillomandibular lesion is very important. Excision of large benign tumors and malignant tumors always leaves major defects that cannot be repaired with conventional reconstructive techniques. Free flap reconstruction is a flexible reconstructive option that can overcome the limitation of conventional approach and restore the essential functions and aesthetics of the facial. The implementation of microsurgery technique at Hanoi National Hospital of Odonto-Stomatology has been carried out for only 12 years but rapid and significant progress has been made.