Oral mucosa reconstruction with a free muscle flap

The use of cutaneous flaps for oral cavity reconstruction is common. However, physiologic reconstruction is not possible because of the presence of hair, and the thickness of cutaneous flaps causes difficulty when performing alveolar ridge augmentation. The authors found few published studies regarding the usefullness of oral reconstruction with free muscle flaps and no studies of histologic examination of reconstructed mucosa. Therefore, they performed a primary reconstruction of oral cavity defects with muscle flaps and allowed the raw surface to epithelialize in 5 patients who underwent oral cavity reconstruction. All flaps were successfully engrafted, and no complications occurred. Epithelialization occurred within approximately 3 months. The authors performed oral mucosal biopsy with the patient’s consent and confirmed that the reconstructed oral mucosa appeared histologically normal. This method is more effective than the use of a cutaneous flap, and the physiologic reconstruction of the oral mucosa and alveolar ridge augmentation can be performed in a single operation. However, it is difficult to use in patients who require radiation therapy after the operation because of the requirement of 3 months for full epithelialization. Additionally, muscle contracture could lead to functional disabilities; thus, this procedure should be performed carefully in patients who exhibit large soft tissue defects or who have hard tissue intervention.