Fibular and iliac crest osteomuscular free flap reconstruction of the oral cavity.
A method for reconstruction of oral cavity soft tissues using segmentally or axially supplied free muscle flaps harvested as a unit with their bone components is presented. Both fibular/soleus and iliac crest/internal oblique free flaps are documented, and the pros and cons of each donor site are presented. Twenty-one patients, 17 with cancer or osteoradionecrosis and 4 with benign or congenital conditions of the mandible, have undergone this operation. Ten bone grafts were simultaneously embedded with osseointegrated implants. All free flaps except one survived and resulted in a smoothly mucosalized oral lining. Six patients have had their implants successfully uncovered, all of whom are wearing prostheses. Four other patients are using tissue-borne prostheses. Transfer of free, nonbulky muscle flaps for mucosalized oral soft-tissue reconstruction is feasible in selected patients using first the fibular and, second, the iliac donor site; this soft-tissue technique also contributes to prosthetic dental rehabilitation.
Department of Otolaryngology, Wasington University School of Medicine, St Louis, Mo 63110.
B H
BH
Haughey
J M
JM
Fredrickson
A J
AJ
Lerrick
A
A
Sclaroff
W D
WD
Gay
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical; D016025:Bone Transplantation / Q000009:adverse effects / Q000379:methods*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D015921:Dental Implants; D017267:Dental Prosthesis Design; D005260:Female; D005360:Fibula / Q000601:surgery; D006801:Humans; D007085:Ilium / Q000601:surgery; D008297:Male; D008334:Mandible / Q000601:surgery*; D008339:Mandibular Neoplasms / Q000601:surgery; D008866:Microsurgery; D008875:Middle Aged; D009055:Mouth / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation*; D009747:Nutritional Physiological Phenomena; D016348:Osseointegration; D012119:Respiration; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000009:adverse effects / Q000379:methods*
D015921:Dental Implants