Microvascular free flap transfer for reconstruction of oromandibular defects

econstruction of the mandible presents unique challenges to the head and neck surgeon. Although mandibular defects can result from trauma, infection, congenital deformities, or osteonecrosis, it most commonly occurs following ablative surgery for the treatment of benign or malignant neoplasms. Primary intrabony mandibular carcinoma is rare; therefore, the involvement of the lower jaw is usually secondary to neoplasm extension from the oral cavity or the oropharynx. Although tumour resection to ensure patient survival is a surgeon’s primary concern, not to be overlooked are aesthetic and quality of life parameters. The mandible serves to provide shape for the lower third of the face, a border between the face and neck, and positions the mentum and lower lip. Functionally, it supports masticatory forces and the mandibular dentition as well as the tongue in both position and function. On average, it must sustain a force of 726N with a maximal force occurring at the molar teeth of 4346 N.1