The iliac crest composite flap for oromandibular reconstruction.

Reconstruction of oromandibular defects following tumor ablation remains a complex endeavor. Its outcome greatly influences a cancer patient's quality of life and ability to become re-integrated into society. The number and variety of reconstructive options attest to the complexity of the problem and to the failure of any one method to demonstrate its superiority. We have favored the iliac crest-internal oblique free flap because of the quality of the bone and flexibility of the soft tissues. These qualities make this flap the ideal option for reconstruction of through-and-through defects of the oral cavity. Our experience reveals that this flap is highly successful in restoring functional mastication in most patients and is associated with minimal donor site morbidity. It is important to recognize, however, that it represents one of many available techniques for the reconstruction of composite oral mandibular defects.