One-stage flap reconstruction of mandibular defects

Reconstruction of mandibular defects following severe trauma or resection for malignancy presents a challenge. The mandibular shape and the close relationship of the bone to intra- and extra-oral soft tissues, make surgical procedures difficult. Reconstruction has to correct the bony and soft tissue defects, preserve mandibular functions (mastication, speech and swallowing), and allow the patient to wear dentures and to present an esthetic appearance. Techniques used for mandibular reconstruction have included implants of synthetic materials or rebuilding with autogenous bone grafts, and require a well-vascularized recipient bed. We used the free osteocutaneous scapular and iliac flap techniques, which avoid the disadvantages of local flaps and grafts. They were used in 3 patients after mandibular resection for fibrous dysplasia, osteosarcoma, and squamous cell carcinoma of the oral mucosa invading the mandible, respectively.