Background: This study reviewed 50 cases of oromandibular reconstruction using vascularized free flaps to evaluate functional parameters of results. Patients and Methods: A retrospective study of 50 patients who had oromandibular reconstruction with 73 free flaps. There were 23 iliac crest flaps, 17 fibula flaps, 30 ulnar forearm flaps, and 3 radial forearm flaps. Our study population comprised 13 females and 37 males. The mean age was 57.66 years. Squamous Cell Carcinoma (SCCA) constituted 86% of cases of which 60% were T4 lesions and 13.9% were recurrent cases. The other 14% included osteomyelitis together with different types of tumors. Anterolateral mandibular defects constituted 48.7%. The mean bone gap was 8.13 cm. Functional evaluation was based on University of Washington Questionnaire (UWQ) through phone calls and personal communication with patients. Results: The mean hospital stay was 12.42 days. The external carotid (75%) and facial (18.3%) were the main recipient arteries. The internal jugular (47.05%) was the main recipient vein. Overall flap survival was 95.9%. Three flaps were lost due to unsalvageable venous thrombosis. The major local complications such as; partial flap loss, hematoma, and oromandibular fistula constituted 10% of cases. Speech, swallowing, and chewing were evaluated through (UWQ) and a speech that is “Excellent” and “Good” was found in 43.3% of cases. Swallowing that is “Excellent” and “Good” was found in 53.3% of cases. Cosmetic acceptance was rated good in 63.3% of cases. Conclusion: Vascularized free flap reconstruction of oromandibular defects provides excellent functional and aesthetic results. The majority of patients are able to tolerate regular diet. Intelligible speech and acceptable appearance are restored providing patient satisfaction.
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