Perioperative Malignant Infarct in a Patient undergoing Mandibular Reconstruction with Free Fibular Flap Surgery for Oral Cancer: A Case Report

Oral cancer is among the top three cancers in India. Surgery is the recommended treatment option for early-stage and locally advanced resectable cases. The incidence of perioperative stroke in patients undergoing neck dissection for head and neck cancer is only 0.2%. In the following article, we report the first case of perioperative malignant infarct in a patient undergoing mandibular reconstruction with free fibula flap surgery for oral cancer. An eighty-year-old male diagnosed with locally advanced carcinoma of the oral cavity underwent mandibular reconstruction with free fibula flap surgery. In the perioperative period, he developed malignant infarction involving the right middle and posterior cerebral artery in the immediate postoperative period, however, it was diagnosed after 36 hours of surgery. He was managed conservatively and discharged with a favorable outcome. This case highlights the importance of clinical examination in such a case, along with the difficulties faced in examining the patient in the perioperative period.