Fig. 2.

Case 2 (patient no. 7.) A 38-year-old woman with systemic lupus erythematosus and antiphospholipid syndrome presented with recurrent buccal cancer after previous treatment with tumor resection and left neck dissection. The patient underwent tumor resection and segmental mandibulectomy. Due to poor vessel patency in the left neck, the patient was administered a reconstructive pectoralis major musculocutaneous flap and adjuvant chemoradiation. (A) An oroantral fistula developed on postoperative day 46. (B) Facial computed tomography demonstrated the oroantral fistula and maxillary sinusitis. (C) The oroantral fistula was treated with an anterolateral thigh free flap using the superficial temporal artery and middle temporal vein as recipient vessels. However, an orocutaneous fistula developed in the left mandibular and mid chin areas. (D) The orocutaneous fistula was completely resolved following an anterolateral thigh free flap performed with the superficial thyroid artery and external jugular vein as recipient vessels.