Abstract
BACKGROUND: Osteocutaneous flaps are the standard approach for performing reconstruction after a mandibulectomy. Soft tissue reconstruction alone may be performed for tumor progression or patient burden; however, it may cause a loss of oral function and issues concerning cosmetic appearance. We performed secondary revision surgery using the tensor fascia lata. This report presents a contour revision surgery for one case in which optimal flap selection was not possible during immediate reconstruction due to various reasons. METHODS: A 63-year-old woman with idiopathic thrombocytopenic purpura and left lower gingival cancer (pT4a N3, M0, Stage IVa) underwent left hemimandibulectomy and left neck dissection. Reconstruction was performed with a deep inferior epigastric perforator flap. Two years after the surgery, we performed a flap volume reduction and created a tensor fascia lata sling to correct a significant irregularity of the mandibular contour. The mandibular contour was greatly improved after revision surgery, and controlled occlusion was possible. A quality-of-life assessment indicated an improved cosmetic appearance. CONCLUSION: This method is relatively simple and less invasive than bone grafting. It potentially solves some problems associated with mandibular reconstruction using only soft tissue.