RECONSTRUCTIVE TECHNIQUE FOR CENTRAL MANDIBULECTOMY DEFECT USING PECTORALIS MAJOR OSTEOMYOCUTANEOUS FLAP

A 70-year-old male with well-differentiated squamous cell carcinoma of the floor of the mouth underwent wide local excision with central segmental mandibulectomy and immediate reconstruction using a pectoralis major osteomyocutaneous (PMOMC) flap incorporating the sixth rib. The surgical approach has successfully restored mandibular continuity and oral function. Post-operative recovery was uncomplicated, with satisfactory cosmetic results and preserved swallowing, speech, and mastication functions. The PMOMC flap has well demonstrated minimal donor site morbidity while eliminating the need for microvascular surgery. This case demonstrates the efficacy of PMOMC flap reconstruction in elderly patients with comorbidities, offering benefits including reduced operative complexity, preservation of natural mandibular anatomy, and favourable functional outcomes compared to free tissue transfer techniques. The technique represents a viable alternative for mandibular reconstruction in appropriately selected patients.