Repair of skin covering osteoradionecrosis of the mandible with the fasciocutaneous supraclavicular artery island flap: case report.

INTRODUCTION

Osteoradionecrosis of the mandible is a serious complication following radiotherapy for head and neck cancer. Reconstructive procedures in the head and neck region use a wide range of flaps for defect closure. The methods range from local, mostly myocutaneous flaps and skin grafts to free microsurgical flaps to ensure a satisfactory functional and aesthetic result. Moreover, the donor site defect needs to be closed, with as little as possible functional or aesthetic impairment.

PATIENT AND METHOD: A 60-year-old male is presented with a history of squamous cell carcinoma of the left lower lip and chin area in whom the tumour was resected and treated by adjuvant radiotherapy. The follow-up was complicated by chronic inflammation of the left mandibular body as a sequel of radiotherapy; it resulted with partial bone destruction, and soft tissue dehiscence. He was admitted for repair and treatment of the infected mandibular osteoradionecrosis. A supraclavicular artery island flap was used to close the mandibular soft tissue defect.

CONCLUSION

The shoulder provides a relatively good skin texture and match to provide cover and lining for defects in the lower part of the face, in combination with minor donor site morbidity.