No abstract

Background While a single‐stage free‐flap reconstruction is the preferred approach for oromandibular defects, a multistaged approach may be necessary in rare cases. These patients can still be effectively restored with functional and aesthetic improvements. Methods We report two cases with a history of bilateral failed fibula free flaps. We detail the multistaged reconstruction to repair these complex defects and discuss the considerations when planning such procedures. Results Both patients successfully underwent a staged reconstruction with an iliac crest osteocutaneous flap following either a rectus abdominis or pectoralis major myocutaneous flap. Conclusion Oromandibular reconstruction is an expected outcome in the contemporary management of oral cavity cancer and osteoradionecrosis. However, complications do occur and can be devastating. In cases of bilateral failed fibula free flaps, a staged approach is a favorable option. Moreover, the iliac crest provides an important reconstructive option with the documented potential for implant born dental rehabilitation.