[A pediculate commissural flap. Its use in the closing of orostoma in irradiated areas]

The arch-like pediculated commissural flap utilizes the cutaneous layer of the lower lip, the chin and the sub-mental region which are usually not affected by radiation fields in tumours of the longue, the floor and the gum. Its vascularisation which at first sight appears paradoxical, results from anastomoses between the sub-mental facial artery and the mental branches of the lower dental artery, and those of the buccal artery, a branch of the internal maxillary and the labial coronaries. Used successfully on five occasions, and in one or two operative phases, this flap enables rapid closure of an orostoma within an irradiated field using the only suitable tissue in the immediate vicinity.