Free rib graft reconstruction of the mandible: a forgotten option?

Eleven patients underwent primary mandibular reconstruction following resection of a head and neck squamous cell carcinoma. Reconstruction consisted of a free rib graft and a pectoralis major myocutaneous flap. One rib graft failed and one graft, although successful, required removal during a wider resection for tumour recurrence. A further three patients have died since operation, two from tumour recurrence and one from unrelated medical causes. Six patients have undergone long-term follow-up of between 22 and 78 months with a mean of 51 months. They have oral continence, take a normal or semisolid diet, and have satisfactory cosmesis. We present the first long-term follow-up of a series of patients undergoing mandibular reconstruction with a free rib graft and pectoralis major myocutaneous flap.