Maxillary reconstruction with the scapular angle osteomyogenous free flap

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Maxillary defects pose significant reconstructive challenges.
• Free-tissue transfer techniques are crucial for restoring function and aesthetics.
• The scapular angle osteomyogenous flap is a reconstructive option for complex maxillary defects.

Purpose of the Study:

• To evaluate the efficacy and outcomes of the scapular angle osteomyogenous flap for maxillary reconstruction.
• To analyze complication rates, functional outcomes, and donor site morbidity associated with this flap.

Main Methods:

• Retrospective review of 39 patients undergoing scapular angle reconstruction for maxillary defects (2004-2010).
• Classification of maxillary defects and analysis of early/late complications.
• Assessment of shoulder function using the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire.

Main Results:

• Overall complication rate was 46%, with 41% requiring revision surgery.
• Fistula formation occurred in 21% of patients, with 50% closing spontaneously.
• Dietary function improved in 46% of patients; shoulder dysfunction (mean DASH score 10.44) was not correlated with neck dissection.

Conclusions:

• The angular scapular flap offers advantages for complex maxillary reconstruction.
• Local complications and the need for revision surgery are common.
• Donor site morbidity appears relatively low, and fistulas often resolve spontaneously.