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The Internal Oblique-Iliac Crest Osseomyocutaneous Free Flap in Oromandibular ReconstructionReport of 20 Cases
Mark L. Urken, MD;
Carlin Vickery, MD;
Hubert Weinberg, MD;
Daniel Buchbinder, DMD;
William Lawson, MD, DDS;
Hugh F. Biller, MD
Arch Otolaryngol Head Neck Surg. 1989;115(3):339-349.
Abstract
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• Microvascular free tissue transfer techniques using composite flaps are the most reliable method for the combined bone and soft-tissue reconstitution of oromandibular defects. Functional oromandibular reconstruction requires that maximum tongue mobility be achieved along with dental prosthetic rehabilitation. The internal oblique-iliac crest osseomyocutaneous microvascular free flap was used in 20 patients for oromandibular reconstruction. The internal oblique muscle, based on the ascending branches of the deep circumflex iliac artery and vein, was used to resurface mucosal defects of the oral cavity and pharynx. The iliac bone, because of its length, width, and natural contour, is the best source of vascularized bone for mandibular reconstruction. The improved soft-tissue component of this composite flap markedly improved the functional results. Reconstruction failed in one patient. Eleven patients underwent dental rehabilitation with either a tissue-borne or osseointegrated implant-borne denture. Follow-up of longer than one year showed minimal donor site morbidity.
(Arch Otolaryngol Head Neck Surg 1989;115:339-349)
Author Affiliations
From the Departments of Otolaryngology (Drs Urken, Lawson, and Biller), General Surgery/Division of Plastic Surgery (Drs Vickery and Weinberg), and Oral and Maxillofacial Surgery (Dr Buchbinder), Mount Sinai Medical Center, New York.
Footnotes
Accepted for publication Sept 30, 1988.
Read before the Second International Conference on Head and Neck Cancer, Boston, Aug 2, 1988.
Reprint requests to Department of Otolaryngology, Mount Sinai Medical Center, 1 Gustave L. Levy Pl, New York, NY 10029 (Dr Urken).
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