Free jejunal graft for reconstruction of oral, oropharyngeal, and pharyngoesophageal defects.

A free jejunal graft was used either as a patch or as a conduit in 40 cases of reconstruction of the oral cavity, hypopharynx, and upper esophagus. Compared with previous intraoral reconstructive techniques using skin or myocutaneous flaps, one-stage free jejunal grafts result in low morbidity, rapid postoperative recovery, and no additional head and neck scars. Because of secure vascularization, the retention of temporary mandible implants is made safer. In addition to tongue reconstruction, facial contouring can also be achieved by the use of mesenteric fatty tissue. The well-vascularized physiologic lining created by utilizing the jejunal graft is highly resistant to mechanical stress and postoperative radiation therapy.