Hard palate reconstruction with a pedicled osteomyocutaneous mandible flap: case report.

Oncologic resection of palatal neoplasms will predictably lead to significant oral dysfunction, affecting both speech intelligibility and deglutition. The resulting velopharyngeal insufficiency may be corrected with the fabrication of an obturator or by flap reconstruction. The use of obturators is associated with a decrease in operating time and elimination of flap donor site morbidity, whether regional or distant. Disadvantages associated with a prosthesis include a prolonged fabrication process of up to 1 year and the high cost, as well as the need for regular removal and cleaning by the patient. Alternatively, flap reconstruction provides for immediate and permanent correction of the oronasal communication, but increases operating room time and is associated with the possibility of donor morbidity at the flap harvest site. The pedicled osteomyocutaneous mandible flap has shown utility in the reconstruction of composite mandibular defects.1 Its use as a method of reconstructing the hard palate represents a novel application of this flap, which is described herein using an illustrative case example.