Immediate reconstruction of the composite mandibular defect using a vascularized osteocutaneous scapular flap: Report of a case.

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A case of mandibular reconstruction using a vascularized osteocutaneous scapular flap was reported.<BR>The patient was a 52-year-old man with squamous cell carcinoma of the floor of the mouth. An osteocutaneous scapular flap of 10 × 14 cm in size was designed based on the circumflex scapular branch of the subscapular artery to reconstruct a surgically-made defect at the floor of the mouth including the tongue and gingival mnucosa.<BR>A bone fragment of 12 cm long was cut at two points and fixed with Kirschner's wires and interosseous wiring. The donor artery and vein were anastomosed with the right superior thyroid artery and external jugular vein respectively.<BR>Bone scan was positive at eight weeks postoperatively despite osteotomies. To enable the patient to wear his denture, flap debulking was carried out. Donor site morbidity was minimal.<BR>We concluded that a vascularized osteocutaneous scapular flap was useful for reconstruction of composite mandibular defects in place of a vascularized osteocutaneous groin flap.