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Reconstruction of complex maxillectomy defects with the scapular-free flap
M S Granick1, S S Ramasastry, E D Newton
1Department of Surgery, Hahnemann University, Philadelphia, Pennsylvania.
Head & Neck
|September 1, 1990
Summary
The scapular free flap effectively reconstructs complex maxillectomy defects, restoring facial contour and function. This microvascular technique offers a valuable solution when simpler methods fail, with high success rates.
Area of Science:
- Plastic Surgery
- Head and Neck Reconstruction
- Microsurgery
Background:
- Maxillectomy defects often require complex reconstruction beyond skin grafts or prostheses.
- Restoration of composite tissue is crucial for optimal functional and aesthetic outcomes.
Purpose of the Study:
- To evaluate the efficacy of the scapular microvascular-free flap in reconstructing maxillectomy defects.
- To assess functional and aesthetic results in patients undergoing maxillectomy reconstruction.
Main Methods:
- Retrospective review of 11 patients undergoing maxillectomy reconstruction using scapular free flaps.
- Flaps were utilized as cutaneous (3 patients) or osteocutaneous (8 patients) based on individual needs.
- Detailed assessment of facial contour, palatal function, and donor site complications.
Main Results:
- Excellent to satisfactory outcomes in 10 out of 11 patients, demonstrating effective restoration of facial contour and palatal function.
- One instance of flap failure was recorded.
- No complications were reported at the flap donor sites.
Conclusions:
- The scapular free flap is a versatile and effective option for reconstructing complex maxillectomy defects, addressing bony and soft tissue loss.
- It provides essential support for the velum, oronasal separation, orbital support, and maxillary sinus obliteration.
- Despite limitations like bone contour and flap thickness, it remains a valuable tool in head and neck reconstructive surgery.