Use of Combined PMMC and Nasolabial Flap for Reconstruction of Full Thickness Cheek Defect Involving Lip Commisure.

Head neck cancer constitute significant cancer burden and among it carcinoma of oral cavity involving buccal mucosa is most common entity in India. Very often it involves lip commisure. Radical surgery along with radiotherapy still remains treatment of choice. Reconstruction of composite defect of oral cavity fallowing ablative surgery remains difficult task. Reconstruction of lip commisure defect after primary tumor excision is still a big challenge. Micro vascular technique primary repair is main modality of treatment which needs great surgical expertise in plastic surgery which is not possible in every institution. We propose a novel surgical reconstructive technique of use of combine pectoralis major myocutaneous flap (PMMC) with nasolabial flap for full thickness cheek defect involving large lip commisure. Both flaps having distinct advantage of relative ease in elevating flap and robust vascularity with acceptable aesthetic and functional outcome.