Microsurgical reconstruction of complex oromandibular defects: An update

Injury. 2019 Dec;50 Suppl 5:S117-S122. doi: 10.1016/j.injury.2019.10.061. Epub 2019 Oct 23.


Free flaps are the gold standard for reconstruction of the mandible, tongue and floor of the mouth. Free fibular flaps are the most preferable option for reconstruction of complex mandibular defects, as well as for tongue and mouth floor reconstruction, since they are harvested easily, present excellent sculptability and good functional outcomes. Alternative options for bone reconstruction include the fibular and iliac crest free flap, and for soft tissue reconstruction include the anterolateral thigh, the radial forearm free flap, and the nasolabial island flap. The principles of the surgical approach include resection of the mandibular segment, intraoperative evaluation of the defect, and various surgical manipulations of the flap on site to reconstruct the defect. Advances in computerized preoperative planning have allowed virtual simulation of the defect and fabrication of an individualized stereolithic mandibular model. This short review discusses the current trends of bone and soft tissue flaps for complex oromandibular reconstructions aiming to present a comprehensive review that the readers would find interesting and informative.

Keywords: Fibula graft; Free flap; Mandible; Microsurgery; Tongue.

Publication types

  • Review

MeSH terms

  • Adult
  • Bone Transplantation / methods*
  • Fibula / surgery
  • Forearm / surgery
  • Free Tissue Flaps*
  • Humans
  • Ilium / surgery
  • Mandible / surgery*
  • Microsurgery / methods*
  • Skin Transplantation / methods*
  • Thigh / surgery
  • Tongue / surgery
  • Treatment Outcome