Reconstruction of Combined Oral Mucosa-Mandibular Defects Using the Vascularized Myoosseous Iliac Crest Free Flap

Abstract

The authors present five cases of combined oral mucosa-mandible defects reconstructed with thevascularized internal oblique-iliac crest myoosseous free flap. This technique has many advantages comparedto other conventional methods such as the radial flap, scapula flap, and fibula flap. Vascularized iliac crestflaps provide sufficient high-quality bone suitable for reconstructing segmental madibular defects. Althoughfibular flaps allow longer donor bone tissue to be harvested, the iliac crest can provide an esthetic shape formandibular body reconstruction and also provides sufficient bone height for dental implants. Conventionalvascularized iliac crest myoosseous flaps have excessive soft tissue bulk for reconstruction of intraoral softtissue defects. The modification discussed in the present article can reduce soft tissue volume, resulting inbetter functional reconstruction of the oral mucosa. Another advantage is that complete replacement of theoral mucosa is observed in as early as one month post-operation. The final mucosal texture is much betterthan that obtained with other skin paddle flaps, which is especially beneficial for the placement of dentalimplant prostheses. Donor site morbidity looks to be similar to, if not less than that observed for othermodalities in terms of function and esthetics. For combined oral mucosa-mandible defects, the vascularizedinternal oblique-iliac crest myoosseous free flap shows good results with respect to hard and soft tissuereconstruction.