MANDIBULAR RECONSTRUCTION

Mandibular reconstruction continues to challenge the head and neck surgeon. Although, no method meets all the requirements, free tissue transfer techniques allow us to more consistently and reliably meet the needs of the patient. Each donor site has specific advantages and disadvantages. There must be adequate bone and soft tissue to reconstruct the particular defect. The status of the patient will always play a role in reconstruction selection. If suitable, we believe mandibular reconstruction with vascularized bone provides optimal function and cosmesis. Successful reconstruction requires thoughtful selection of a donor site tailored to each patient¿s needs. We have passed the era when successful oromandibular reconstruction is judged by survival of the flap or graft. With flap survival rates exceeding 95%, the focus is now on function and aesthetics. Objective means to measure functional deficits and postoperative results are available and need to be instituted into meaningful comparative studies.