Mandibular reconstruction in irradiated patients utilizing myosseous-cutaneous flaps.
Myosseous-cutaneous flaps were used for mandibular reconstruction in 16 irradiated patients. Three of six sternomastoid-clavicle flaps failed (all in conjunction with a neck dissection), as did one of 10 pectoralis major-anterior-fifth rib flaps. One trapezius-scapular flap was used and it succeeded. We found the blood supply of the sternomastoid-clavicle flap too tenuous for use in conjunction with a neck dissection. The trapezius-scapular flap had too short an arc of rotation to be used for defects other than those in the horizontal ramus. In addition, this flap required a change of position and created an undesirable functional deformity. The pectoralis major-fifth rib flap, in contrast, could be used for a variety of defects, in conjunction with a neck dissection, and did not require a change of position during operation. We found it to be the most versatile and dependable of the flaps employed in this series.
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000601:surgery*; D008722:Methods; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000628:therapy*; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D010025:Osteoradionecrosis / Q000601:surgery*; D011832:Radiation Injuries / Q000601:surgery*; D013524:Surgical Flaps; D013997:Time Factors