Bilateral functional mandibular reconstruction using the iliac crest free flap. A case report.

A patient who developed multiple metachronous primary carcinomas of the oval cavity is presented. After initial radiation therapy, a right hemimandibulectomy was required, followed ten months later by a left hemimandibulectomy. Immediate reconstruction of each defect was performed with a free vascularized iliac crest osteocutaneous flap. Using this flap, both bony continuity and intraoral lining were successfully restored. The patient was able to return rapidly to his previous activities. The results of this case suggest that preservation of the mandibular condyle for lateral fixation of the bone graft is superior to disarticulation of the temporomandibular joint in terms of cosmetic and functional outcomes.