Composite defects resulting from surgery for advanced oral cancer represent a difficult reconstructive problem and, in some cases, tissutal defects are extensive requiring multiple free flaps. Personal experience is reported with double free-flap technique in the reconstruction of large complex defects in 10 patients treated for T4 oral squamous-cell carcinoma. Fibula osteo-cutaneous free flap was used in association with forearm free flap in 5 cases, fibula osseous-forearm in 3 cases, fibula osseous-rectus abdominis in 1 case, iliac crest-forearm in 1 case. Forearm free flap was used for intra-oral reconstruction in all cases. Total flap survival is 100% and all patients regained adequate oral diet. At the time of evaluation (February 2001), 40% of patients are alive and mean survival rate is 36 months. In conclusion, simultaneous free flap reconstruction, in massive oro-mandibular defects, represents in some selected patients, a good choice to achieve satisfactory aesthetic and functional results.
Oromandibular reconstruction with simultaneous free flaps: experience on 10 cases / Ferrari, Silvano; Ferrari, S.; Poli, T.; Bertolini, F.; Raho, T.; Sesenna, Enrico. - In: ACTA OTORHINOLARYNGOLOGICA ITALICA. - ISSN 0392-100X. - 23(4)(2003), pp. 281-290.
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