The authors state their experiences using trapezius osteomusculocutaneous flaps in 22 clinical patients for primary reconstruction of mandibular defects. The additional investigative study examines the anatomy of 100 osteomusculocutaneous flaps in 50 fresh cadavers. 78 percent of the major vascular pedicle arose form the thyreocervical trunk. The advantages of this method are as follows: 1. This flap provides a well-vascularized bone graft; 2. The operation comparing to other bone grafting methods is simple; 3. After radical neck dissection the trapeziu muscle protects the carotid artery; 4. The vascularized bone graft can be used after irradiation; 5 Good functional and esthetic results can be obtained.