Reconstruction of segmental hemi-mandibular defects using soft tissue flaps in patients with severe comorbidity and advanced head and neck cancer

Abstract EN

Background and Purpose : The standard of care to reconstruct segmental oro-mandibular defects following head and neck oncological resection is to use osseocutaneous free-tissue transfer.

Some patients however are not suitable for this type of complex reconstruction.

The purpose of this paper is to study our results of soft-tissue flap reconstruction for segmental hemi-mandibular defects.

Patients and Methods : Ten patients were included in the study, all had advanced squamous cell carcinoma of the oropharynx or oral cavity and all had hemimandibulectomies.

Results : In eight cases a vertical rectus abdominis myocutaneous (VRAM) free flap was used and in two cases a pectoralis major myocutaneous pedicled flap was used.

Normal oral feeding was achieved in six patients with a mean time for discontinuation of tube feeding of 18 days.

Conclusion : In selected patients with severe comorbidity and advanced oro-mandibular cancer, soft tissue flaps may be used for segmental hemi-mandibular defects.