Mandibular reconstruction. New concepts.

The combination of a myocutaneous flap with a three-dimensional bendable reconstruction plate has provided satisfactory results in restoration of mandibular defects following surgical resections in irradiated patients. Twenty-eight patients were treated and prospectively evaluated. Patients requiring postoperative irradiation were excluded from this study. Two groups were identified. Group A (N = 23) required a myocutaneous flap to resurface the soft-tissue defect and group B (N = 5) was treated by primary closure. Seventy-three percent (17 of 23) of patients in group A and 60% (three of five) in group B had received presurgical irradiation but required none after surgery. To date, 64% (18) of the patients have maintained their plates for more than one year, half of these for two years or more. Another 21% (6) have had their plates in place more than six months and the remaining 14% (four) less than six months. One plate was lost in an irradiated group B patient.