[Reconstruction of large defects of the oral mucosa with free, revascularized jejunum transplants].

The resection of oropharyngeal cancer often creates large mucosal defects which may impair chewing, swallowing or speech function severely. Therefore, proper reconstruction is crucial for the patient. In five cases with cancer of the floor of the mouth, the tongue, the cheek and the soft palate respectively, a successful reconstruction was achieved by means of a free revascularized jejunal graft. Tumour resection and preparation of the jejunal graft are performed synchronously by two surgical teams. After suturing the graft into the oropharyngeal defect its mesenteric vessels are usually anastomosed to the facial artery and the external jugular vein. Results showed that the jejunal graft is a most adequate substitute for oropharyngeal defects and superior to skin flaps. In a sixth patient the graft was lost because of an arterial thrombosis. This failure was not life threatening, but led to a poor functional result. Postoperative radiation therapy was tolerated by the transplanted jejunal mucosa in spite of a marked inflammatory reaction.