Reconstruction of mandible is of paramount importance following ablative surgery for oral cancer. Though osteocutaneous micro-vascular free flap is generally accepted to be the mainstay of mandibular reconstruction, other reconstructive options are also done for mandibular reconstruction with good results. Seventeen patients of oral cavity cancer involving the alveolus who had underwent hemi-mandibulectomy were reconstructed using 5th rib osteo-pectoralis major myocutaneous flap. Procedure related pleural tear occurred in 3 patients during harvesting of the rib which were repaired intra-operatively with no post-operative complications. There were 2 failures in our series, in the rest 15 patients the flap had taken up; have good oral continence taking semi-solid diet and have satisfactory cosmetic appearance. This study shows that 5th rib osteo-pectoralis major myocutaneous flap is a quick, easy to learn, one stage reconstructive procedure with a good predictable cosmetic and functional outcomes.

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The aim of this clinical study was to find similarities; dissimilarities of neck space infections along with challenges faced by treating physician for their diversified clinical presentations and complications. Patients with neck space infections were compared for the purpose. The classic manifestations of these infections, such as high fever, systemic toxicity, and local signs were not present in all cases leading to dilemma in physician's decision making. They progress towards fatality very fast. Prompt recognition, diagnosis and management of such cases and complications are of paramount importance to reduce morbidity and mortality. In addition to broad spectrum antibiotic therapy along airway protection, surgical drainage is necessary in nearly all cases. Neck space infections still continue to be a well prevalent health problem in poor socioeconomic group in developing countries having significant morbidity as well as mortality.