Mandibular reconstruction in irradiated patients utilizing myosseous-cutaneous flaps

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Oncologic Reconstruction

Background:

• Mandibular reconstruction presents challenges, particularly in irradiated patients requiring myocutaneous flaps.
• Evaluating the efficacy of different flap options is crucial for successful outcomes.

Observation:

• Six sternomastoid-clavicle flaps, ten pectoralis major-anterior-fifth rib flaps, and one trapezius-scapular flap were assessed.
• Flap failures occurred in three sternomastoid-clavicle flaps and one pectoralis major-anterior-fifth rib flap.

Findings:

• The sternomastoid-clavicle flap's blood supply was insufficient for neck dissection.
• The trapezius-scapular flap had limited reach and caused functional deformity.
• The pectoralis major-fifth rib flap demonstrated versatility, dependability, and suitability for neck dissection without repositioning.

Implications:

• The pectoralis major-fifth rib flap is recommended as the preferred choice for mandibular reconstruction in irradiated patients.
• Surgical planning should consider flap limitations and patient-specific factors for optimal reconstruction.
• Further research could explore modifications to improve other flap options.