Utilization of non-vascularized bone graft with regional flap as an alternative for facial reconstruction

Mandibular resections decision is one of the most important steps in oral cavity malignant or nonmalignant lesions associated with the mandible. The role of mandibular reconstruction is not only for cosmesis, but it is also indicated for functional rehabilitation such as swallowing, phonetics, and for facial symmetrical. Even though the free tissue transfer is considered a gold standard for mandibular reconstruction, the importance of nonvascularized bone grafts (NVBGs) such as fibula, calvarium, rib, sternum, and iliac are still persisting in mandibulectomies condition like patient who have not taken radiotherapy or not willing to undergo radiotherapy or not fit for free tissue transfer and provides a good contour of mandibular replacement. The success rate of NVBG depends upon patient selection, preoperative planning, and meticulous nursing care. Addition to NVBG, regional flaps such as pectoralis major myocutaneous (PMMC) flap will help in soft-tissue replacement of the defect as well as it will help in the situation where primary closure and airtight closure is not possible. This case report will discuss in detail about the management of anterior segmental mandibulectomy due to oncological resection and reconstruction with NVBG with fibula and PMMC.