Management of osteoradionecrosis of the mandible with myocutaneous flaps.

Involvement of large areas of the mandible or the entire mandible with osteoradionecrosis may result in severe functional disability and cosmetic deformity. The use of a well-vascularized pectoralis major myocutaneous flap from outside the original field of irradiation has been successful in obtaining functional and cosmetic goals. Myocutaneous flaps provide bulk for contour and tissue support, and their rich vascular supply promotes healing of the heavily irradiated soft tissue and bone. Successful bone grafting for mandibular reconstruction may follow control of the osteoradionecrosis.