Composite Mandibular Reconstruction with Liquid Nitrogen-Treated Autograft and Pectoralis Major Flap

Segmental mandibular defects are typically reconstructed with vascularized bone grafts. Free transfer grafts require microvascular anastomosis, which may be difficult in vessel-depleted necks and high-risk patients. We report a case of squamous cell carcinoma of the lower gingiva involving the mandibular bone. We performed a combination of frozen autograft and pectoralis major (PM) flap to reconstruct the mandibular defect. The tumor was resected en bloc with a mandibular segment. To reconstruct the oral defect, we used liquid nitrogen-treated autograft. The PM flap was wrapped around the reconstructed mandible. Frozen autograft and PM flap combined is both oncologically and cosmetically a good procedure in contemporary oral and maxillofacial surgery.