Dual free flap transfer using forearm flap for mandibular reconstruction.

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic and Reconstructive Surgery
• Oncology

Background:

• Composite mandibular defects often result from oral cancer treatment, necessitating complex reconstruction.
• Traditional methods may face limitations in achieving functional and aesthetic restoration.
• The radial forearm flap offers unique advantages for mucosal lining and vascular bridging.

Observation:

• A dual free tissue transfer technique was employed, combining a vascularized bone graft with a radial forearm flap.
• This procedure was utilized in 17 patients with mandibular defects post-oral cancer treatment between 1982 and 1989.
• The radial forearm flap served as mucosal lining and/or an interpositional flap, acting as a vascular bridge.

Findings:

• The dual free tissue transfer technique demonstrated significant advantages for mandibular reconstruction.
• It proved effective in creating a satisfactory alveolar ridge for patients with composite mandibular defects.
• The procedure is applicable even with a single pair of recipient vessels, potentially located at a distance from the defect.

Implications:

• This technique offers a viable solution for complex mandibular reconstruction, particularly after oncological resections.
• It expands reconstructive options for patients with limited recipient vessel availability.
• The method facilitates improved functional outcomes, including restoration of the alveolar ridge and masticatory function.