Double-folded free myocutaneous flap to cover a total cheek defect

This is a report of the successful reconstruction in two cases of a total cheek defect after radical maxillectomy with orbital exenteration for cancer of the maxillary sinus, in one stage, utilizing a double-folded free latissimus dorsi myocutaneous flap. The importance of preoperative angiography to identify suitable donor vessels, and of microneurovascular anastomosis to maintain the normal function of the transplanted muscle is stressed.