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Proximity of maxillary molar teeth roots to the maxillary sinus floor can potentiate oroantral communication (OAC) after extraction. Considering the defect size and situation, surgical treatment may become essential. Surgical treatment modalities are variable and would be indicated in special clinical circumstances.In this article, a chronic case of OAC with a size of 25 × 15 mm(2) in a 30-year old man with history of heavy smoking and drug abuse was treated with combination of buccal fat pad (for covering sinus floor), coronoid process pedicled on temporalis flap, and mucosal closure. There was no complication during and after operation. Short- and long-term follow-up revealed success of this novel technique despite the patient's poor compliance.

A 33-year-old lady was referred to the Department of Oral and Maxillofacial Surgery of Taleghani hospital in 2008. She complained of firm swelling on the left side of her face with toothache, lacrimation, and nasal stiffness. There was a large mass in the left maxillary sinus with extension to the orbital floor, nasal bone, ethmoid sinus, and infratemporal fossa. The incisional biopsy revealed a neurofibroma of the maxilla. She underwent hemimaxillectomy and simultaneous reconstruction with temporalis-coronoid flap for orbital floor reconstruction. After 2 months' follow-up with no complication, she complained of left globe upward movement during gum chewing. The orbital and visual examinations were otherwise normal. This unusual complication has continued for 4 years with no resolution, although the patient does not worry about it any more.

Introduction: Reconstruction of the surgically created defects in the head and neck regions is a crucial step in the patients’ treatment plan. Regarding the involved tissues, various flaps and grafts have been introduced in the literature. The pectoralis major myocutaneous flap (PMMF) is one of the most versatile flaps with many variations for providing more advantages. Also, when bone tissue is needed, it can be reconstructed via an osteomyocutaneous flap including rib, sternum, or clavicle. Case Presentation: In this article, a case of oral squamous cell carcinoma with the extension to facial structures and, then, reconstructed with PMMF was presented, in which a medial half of clavicle bone was resected and employed as a free bone graft. Conclusions: Sectioning clavicle not only increases the arc of rotation and mobility of the PMMF but also provides a new source of bone graft in the vicinity. Besides, the survival of the graft and integration with the native bone is noteworthy.