Mandibular reconstruction with metal plate and myocutaneous flap.

The combination of a myocutaneous flap with a three dimensional, bendable reconstruction plate has provided very satisfactory results in restoration of mandibular defects following surgical resections in irradiated patients. Twenty-four cases have been treated and evaluated prospectively using this technique. Patients requiring postoperative irradiation were excluded from this study. Two groups were identified. Group A (n = 20) required a myocutaneous flap to resurface the soft tissue defect and Group B (n = 4) were treated by primary closure. No failures were encountered in the group handled primarily with a myocutaneous flap combined with an AO plate. One failure occurred in the group closed primarily. Nine (38%) of the patients have maintained their plate for over 1 year. Twelve (55%) have functioned for more than 9 months. Of the remaining three (7%), one failed and the other two have been in place for more than 5 months. The results of this study demonstrate that a well-vascularized soft tissue bed in combination with stainless steel plate provides a very satisfactory, functional, esthetic and reliable method in rehabilitation of mandibular defects primarily in irradiated patients.