Pedicled mandible myo-osseous flaps combined with free skin flaps for reconstruction of complex lateral mandibular defects

Background This study presents an alternative in reconstruction, using free skin flaps in combination with pedicled mandible bone flaps for complex lateral mandibular defects. Methods. In all, 13 patients were included in this prospective study. Pedicled mandible myo-osseous flaps were used for reconstruction of bone defects of the lateral mandible in combination with free skin flaps, including radial forearm flaps (n = 3), anterolateral thigh (ALT) flaps (n = 9), and local tongue flap (n = 1). Postoperatively, a Tc-99m-methyl diphosphonate bone scan was performed to assess bone flap viability. Results. All patients had acceptably contoured mandibles. The major complications consisted of 1 failed ALT flap and 2 nonviable bone flaps. The bone scan confirmed viable bone flaps in 11 cases. Ten patients (77%) were able to resume soft to full diets. Conclusions. For complex lateral mandibular defects (<= 6 cm), a combination of the pedicled mandible myoosseous flaps and free skin flaps is an alternative in reconstruction. (C) 2011 Wiley Periodicals, Inc. Head Neck 34: 384-392, 2012