The Use of Three Iliac Crest Muscles for Head and Neck Soft Tissue Reconstruction: Technical Note

This technical note describes a novel approach to reconstructing soft tissue in the head and neck region by diverting a flap originally intended for hard tissue reconstruction. We present a case of a 79-year-old woman with a large tumor on the left side of the mobile tongue, where the use of a radial free flap was challenging. Instead, we used the muscular portion of the iliac crest as a reliable alternative for reconstruction, offering a suitable oral lining. Using a muscular free flap, we achieved effective tongue reconstruction while minimizing donor site morbidity. The deep circumflex iliac artery muscular free flap demonstrates promising outcomes for large defects in the oral cavity and facial regions. However, a comprehensive case series with functional assessments and long-term follow-up is necessary to evaluate potential complications, such as hernia formation.