Evolution in the range of free flaps available for head and neck cancer has facilitated successful reconstructive surgery in increasingly demanding defects. Patients presenting with extensive primary or recurrent tumours, as well as cases of osteoradionecrosis, form a significant part of the head and neck reconstructive surgeon's practice. These cases often incorporate complex three-dimensional defects that include both osseous and soft tissue components as well as more than one epithelial surface (e.g.
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