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KMID : 0358819890160050857
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Journal of Korean Society of Plastic and Reconstructive Surgeons
1989 Volume.16 No. 5 p.857 ~ p.865
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MANDIBULAR RECONSTRUCTION BY USE OF THE PECTORALIS MAJOR OSTEOMYOCUTANEOUS FLAP AFTER COMMANDO OPERATION IN IRRADIATE INTRAORAL MALIGNANCY
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Cheong Jae-Heun
Lee Young-Ho
Han Byung-Kye
Lee Hye-Kyung
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Abstract
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Mandibular reconstruction is one of the most challenging problems after resection of irradiated intraoral malignancy in plastic surgery.
Traditional non-vascularized bone grafting techniques often failed due to the irradiated or bacterially contaminated recipient beds, in addition to the poor nutritional status of the patients. Among the vascularized bone grafts, the free flap containing bone, while having numerous advantages, do require prolonged operation time, sophisticated equipment and special expertise, and be limited to apply in irradiated recipient beds.
Therefore, in older or debilitated patients, mandibular reconstruction using a pedicled osteomyocutaneous flap would be more reliable and possibility of complications less than free flaps. Authors expericenced manidbular reconstruction utilizing the pectoralis osteomyocutaneous flap containing the fifth costal segment in 4 cases who had full dose of irradiation preoperatively and "commando" operation.
1. This flap is the most reliable and dependable in older and debilitated patients who had peroperative irradiation for intraoral malignancy.
2. To prevent the malunion or non-union interosseous rigid fixation will be necessary using the miniplate or metal mesh rarher than wire.
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