A case of one-stage free rectus abdominis myocutaneous flap was reported. The patient was a 68 year old male with a very small primary cancer lesion in the right molar region of the mandible.
However, the X-ray films at first visit (30-9-1988) showed abnormal figure.
He was clinically diagnosed as mandibular cancer (T3N0M0). He had taken radiotherapy of Linac 2, 000 rads from June 13th to June 24th before operation.
In as much as cervical lymph node metastasis was absent, we decided to operate on the mandibular cancer lesion.
We used a free rectus abdominis myocutaneous flap to replace the loss of the mandible and the mouth floor.
The mouth floor and the mandible were resected continuously at the 8-3 portion (and the mouth floor) and an upper neck dissection was performed.
An A-O plate and a free abdominis myocutaneous flap was put in place in the mouth to close the defect.
The flap was revascularized by anastomosing the inferior epigastric artery and vein to the facial vessels. The flap being well revascularized, no functionary morbidities occurred after its replacement. A denture was constructed after 6 months. The prognosis for this case is satisfactory. The main characteristics of this flap are as follows:
(1) The flap is very easily and quickly elevated with the patient in a supine position.
(2) In many cases flap elevation and oral cancer surgery can be performed simultaneously, thereby reducing operating time.
(3) There are very few anatomical variations in the deep inferior epigastric vessels.