title: Reconstruction of segmental hemi-mandibular defects using soft tissue flaps in patients with severe comorbidity and advanced head and neck cancer.
abstract: OBJECTIVE
  The standard of care to reconstruct segmental oro-mandibular defects following head and neck oncological resection is to use osseocutaneous free-tissue transfer. Some patients however are not suitable for this type of complex reconstruction. The purpose of this paper is to study our results of soft-tissue flap reconstruction for segmental hemi-mandibular defects.
  
  
  METHODS
  Ten patients were included in the study, all had advanced squamous cell carcinoma of the oropharynx or oral cavity and all had hemimandibulectomies.
  
  
  RESULTS
  In eight cases a vertical rectus abdominis myocutaneous (VRAM) free flap was used and in two cases a pectoralis major myocutaneous pedicled flap was used. Normal oral feeding was achieved in six patients with a mean time for discontinuation of tube feeding of 18 days.
  
  
  CONCLUSIONS
  In selected patients with severe comorbidity and advanced oro-mandibular cancer, soft tissue flaps may be used for segmental hemi-mandibular defects.
  
  
  BACKGROUND
  Oral cavity cancer - Free tissue transfer.
authors.affiliation: The Departments of Ear Nose & Throat-Head / Neck Surgery, Guy's & St Thomas'NHS Foundation Trust, London, UK.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Jeannon
authors.forename: Ahmad
authors.initials: A
authors.lastname: Orabi
authors.forename: Mark
authors.initials: M
authors.lastname: McGurk
authors.forename: Roy
authors.initials: R
authors.lastname: Ng
authors.forename: Paul
authors.initials: P
authors.lastname: Roblin
authors.forename: Ricard
authors.initials: R
authors.lastname: Simo