Abstract: PURPOSE: Plate exposure was the most common complication following reconstruction after oncological resection using a titanium plate, we evaluated the outcomes of covering exposed reconstructive mandibular plates with extended vertical lower trapezius island myocutaneous flaps (TIMFs) in the present study. METHODS: Twelve patients with exposure of reconstructive plates were treated following segmental mandibulectomy due to cancer of the oral cavity and oropharynx. We covered the plates with extended vertical lower TIMFs. The primary site of tumor was located in gingiva/mandible in 5 cases, buccal mucosa in 3 cases, the floor of the mouth in 2 cases, and the base of the tongue in 2 cases. The types of bone defect were hemi-mandible in 1 case, central defect in 2 cases, and lateral defect in 9 cases. Intraoral, extraoral, and intra-extraoral exposure occurred in 1, 7 and 4 cases, respectively. Intraorally and extraorally exposed plates were re-covered with skin paddles measuring 6 cm×7 cm to 6 cm×23 cm (average, 6.0 cm×13.5 cm). Four folded extended vertical lower TIMFs were used to cover the plates exhibiting intra-extraoral exposure. RESULTS: All flaps survived. Patients were followed-up for 12-36 months (mean time 22.8 months). One patient (8.3%) exhibited external plate exposure at 20 months. Nine patients (75.0%) were alive with no evidence of disease at 12-36 months and two (16.7%) were alive with disease at 20-28 months. One patient (8.3%) died of local recurrence at 23 months. CONCLUSIONS: The use of extended vertical lower TIMFs to cover intraorally, extraorally, or intra-extraorally exposed plates is reliable.

Key words: Oral cancer, Trapezius flap, Mandibular defects, Titanium plate