Reconstruction Using Pedicled Latissimus Dorsi-Rib Osteomyocutaneous Flap for Mandible-Invading Oral Cavity Cancer

The most commonly used flaps for mandibular reconstruction following segmental mandibulectomy are osteocutaneous free flaps, with the fibula, iliac crest, and scapula being the primary sources. However, an appropriate method for patients who are not suitable candidates for free flap reconstruction has not been well established. A 61-year-old male underwent a recurrence of extensive oral cancer. Through a visor flap approach, extensive resection of the oral cavity and oropharynx, subtotal hemi-mandibulectomy, and resection of the submental skin were performed. To reconstruct the defect, a pedicled flap including a 7 cm rib and a 20× 7 cm latissimus dorsi (LD) flap vascularized by the descending branch of the right thoracodorsal artery was utilized. The rib was used to reconstruct the mandible, and the LD flap was divided into two parts to reconstruct each oral cavity, oropharynx, and submental skin. Postoperative recovery was successful with no significant complications, flap, or rib necrosis.