Latissimus Dorsi-Rib Pedicle Flap for Mandibular Reconstruction as a Salvage Procedure for Failed Free Fibula Flap

Background: Mandibular reconstruction is usually performed by using free vascular flaps. However, there are instances in which it must be carried out with pedicle flaps. Insofar, the main option recommended is the pectoralis major (PM) + rib pedicle flap.Methods: A 45-year-old patient affected by a primitive mandibular tumor presented after an unsuccessful reconstruction with free fibula flaps. He refused a PM + rib pedicle reconstruction, while he accepted to undergo a latissimus dorsi (LD) + rib flap reconstruction.Results: The postoperative course was uneventful. Also, the range of movements of the upper limb involved in the operation showed no significant changes after surgery.Conclusions: The LD + rib flap proved to be a useful alternative procedure for mandibular reconstruction after cancer ablation in patients who are not candidates for vascularized bone-containing free flaps and refuse the PM + rib flap reconstruction.