ABSTRACT
The technique of choice for reconstruction of segmental mandibular defects following cancer resection is primary microvascular bone transfer and the favored donor sites are iliac crest, fibula, and scapula. Alternative methods for primary or secondary mandibular reconstruction include the use of mandibular reconstruction plates (MRP), free nonvascularized bone grafts, bone cribs, and pedicled vascularized bone grafts. Segmental mandibular defects that are left to swing freely with no attempt at reconstruction may result in significant aesthetic and functional morbidities depending on the size and location of the defect. Use of pedicled vascularized bone including trapezius-scapular spine, pectoralis major-rib, and latissimus dorsirib has been reported but avascular necrosis of the bone segment is frequent, probably due to the tenuous periosteal blood supply from the muscle to the bone (1). The method of choice depends on the condition of the neck and surrounding tissues and the size and location of the mandibular and associated soft tissue defects. The overall health, prognosis, and desires of the patient and the suitability of potential donor sites are also important considerations.
