FIBULAR AND ILIAC CREST OSTEOMUSCULAR FREE-FLAP RECONSTRUCTION OF THEORAL CAVITY

A method for reconstruction of oral cavity soft tissues using segmenta lly or axially supplied free muscle flaps harvested as a unit with the ir bone components is presented. Both fibular/soleus and iliac crest/i nternal oblique free flaps are documented, and the pros and cons of ea ch donor site are presented. Twenty-one patients, 17 with cancer or os teoradionecrosis and 4 with benign or congenital conditions of the man dible, have undergone this operation. Ten bone grafts were simultaneou sly embedded with osseointegrated implants. All free flaps except one survived and resulted in a smoothly mucosalized oral lining. Six patie nts have had their implants successfully uncovered, all of whom are we aring prostheses. Four other patients are using tissue-borne prosthese s. Transfer of free, nonbulky muscle flaps for mucosalized oral soft-t issue 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.