ABSTRACT
En bloc defects, which can also be defined as extensive composite defects, present as one of the most complex reconstructive challenges in the head and neck area. Although most head and neck defects can be reconstructed using a single free tissue transfer, the use of two free flap is indicated for massive tissue defects or for composite tissue requirement that cannot be met with a single free flap. In this paper, we report two patients with composite defects. They underwent single-stage, double free flap reconstruction utilizing a fibular osteoseptocutaneous flap to reconstruct the mandible and floor of the mouth, as well as an innervated radial forearm fasciocutaneous composite flap with the palmaris longus tendon and the latissimus dorsi free flap for the total tongue reconstruction. Both patients had acceptable functional and aesthetic outcomes.