Free Chimeric Scapular with Latissimus Dorsi Myocutaneous Flap as a Third Free Flap for Reconstruction of...

This is a rare case report in which a third free flap was used to restore metachronous mandibular defects. Significant functional and aesthetic losses may result from segmental mandibular excision in cases of oral cancer. The fibula flap is the gold standard for reconstructing these defects, which is essential for regaining shape and function. Reconstruction attempts become more complex when individuals experience metachronous malignancies or recurrence. We present a rare instance in which a third free flap was required for restoration following 2 metachronous mandibular defects. Mandibular continuity was effectively restored using a free chimeric scapular with latissimus dorsi myocutaneous flap, yielding positive functional and cosmetic results. This case report shows that even after prior reconstruction, patients can successfully undergo an additional free flap procedure, improving their quality of life. It further underscores the adaptability and effectiveness of this reconstructive technique in correcting complex mandibular defects.