Immediate repair of mandibular defects following surgery for carcinoma of the lower alveolus and gingiva using a pectoralis major osteomyocutaneous flap.

During the two years from 1981 to 1983, a pectoralis major myocutaneous island skin flap, with the 5th rib or sternum, has been used for immediate repair of mandibular defects following surgery in five cases of carcinoma of the lower alveolus and gingiva. In these 5 patients with segmental and hemimandibulectomy, immediate mandibular reconstruction was performed simultaneously using a flap with the 5th rib or the sternum. Thereafter, in 3 of them, the contour and function of the mandible were restored by prosthetic appliances. In the remaining 2 patients prostheses could not be used because of mandibular discontinuity due to removal of a portion of the graft because of postoperative infection and pseudo-arthrosis. Mandibular reconstruction using the osteomyocutaneous flap is advantageous in the restoration of the contour and function of the mandible. Some problems concerning the reconstruction will be reported.