Functional oromandibular reconstruction with the microvascular composite groin flap

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Oromandibular defects often result from cancer resection or trauma, significantly impacting speech, swallowing, and quality of life.
• Microvascular free flaps offer a viable solution for complex oromandibular reconstruction, aiming to restore both form and function.

Observation:

• Ten patients underwent reconstruction using a microvascular osteocutaneous groin flap for oromandibular defects.
• The flap utilized superficial and deep circumflex iliac vessels for precise bone and skin placement.
• Functional assessments included speech intelligibility and swallowing evaluations, with cineradiography used for detailed analysis.

Findings:

• Patients with major glossectomies and arch resections achieved intelligible speech and could consume a soft diet without aspiration.
• Cineradiographic studies highlighted the critical role of intraoral flap shape and bone graft positioning in successful swallowing and aspiration prevention.

Implications:

• The microvascular osteocutaneous groin flap is a reliable technique for restoring oromandibular function after defect reconstruction.
• Understanding the biomechanics of flap design and graft placement is essential for optimizing functional recovery, particularly in swallowing.
• This reconstructive approach offers significant potential for improving the quality of life for patients with extensive oromandibular defects.