Neurovascular musculocutaneous latissimus dorsi free-flap transfer for reconstruction of a major cheek defect with facial palsy in a 14-month-old child.

This report deals with a female infant 14 months old at time of surgery. Three weeks before admission, she suffered a direct blow to the left cheek by hitting a table. Within 24 h, she developed a hematoma involving the whole cheek. Ten days later, she developed an eschar on the cheek and was referred to us. Three weeks after the initial trauma, the damaged tissues were debrided, including the skin, subcutaneous tissue, and muscle. The buccal mucosa remained intact. Facial palsy involving the territory of the buccal and mandibular branches was already evident at 3 weeks, as well as facial asymmetry. Consequently, a free musculocutaneous neurovascular latissimus dorsi free flap was proposed to restore the volume, shape, and function of the left half of the face. We present the surgical technique and the results 3.5 years later.