Reconstruction of mandibular defects with the revascularized free tensor fascia lata osteomyocutaneous flap.

In recent years, experience with microvascular surgery has enabled the use of free vascularized bone grafts to bridge mandibular defects. Such grafts have several advantages over conventional nonvascularized bone grafts. Advantages include improved survival and more rapid healing in poorly vascularized recipient sites, less risk of absorption, and greater resistance of the graft to infection and subsequent extrusion. Several free osteocutaneous rib grafts have been reported for mandibular replacement; however, only a few reports have advocated the use of free compound flaps that use iliac crest bone. Two cases of immediate mandibular reconstruction used the revascularized free tensor fascia lata osteomyocutaneous flap. This flap uses revascularized iliac crest bone. Viability of one bone graft was confirmed by scintigraphy ten days after transfer of the compound flap.