Bilateral functional mandibular reconstruction using the iliac crest free flap. A case report

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Multiple metachronous primary carcinomas of the oral cavity present complex treatment challenges.
• Previous management often involves extensive resection and reconstruction, impacting function and aesthetics.

Observation:

• A patient with multiple oral cavity cancers underwent sequential right and left hemimandibulectomies after radiation therapy.
• Reconstruction utilized free vascularized iliac crest osteocutaneous flaps for immediate defect repair.

Findings:

• The iliac crest flap successfully restored both bony continuity and intraoral lining after hemimandibulectomy.
• Preservation of the mandibular condyle for lateral fixation yielded superior cosmetic and functional results compared to temporomandibular joint disarticulation.

Implications:

• This technique offers a viable solution for complex mandibular defects in oral cancer patients.
• Preserving the mandibular condyle is recommended for optimizing functional and aesthetic recovery in reconstructive surgery.