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Reverse-flow scapular osteocutaneous flap for head and neck reconstruction.
Jose P Zevallos1, Mark L Urken
1Department of Otolaryngology/Head and Neck Surgery, Beth Israel Medical Center, New York, New York, USA.
Head & Neck
|April 11, 2012
Summary
The reverse-flow scapular osteocutaneous flap is a safe and effective option for complex head and neck reconstruction, especially in vessel-depleted necks. This technique offers a reliable solution for mandibular reconstruction when traditional methods are not feasible.
Area of Science:
- Surgical Reconstruction
- Head and Neck Surgery
- Microsurgery
Background:
- Scapular osteocutaneous flap is versatile for head and neck defect reconstruction.
- This study focuses on the reverse-flow variation in vessel-depleted necks.
Observation:
- Retrospective review of 3 patients undergoing reverse-flow scapular osteocutaneous flaps.
- Indications included recurrent desmoid tumor, alveolar ridge carcinoma, and osteoradionecrosis.
- All patients had prior neck dissection and radiotherapy, necessitating contralateral neck exploration for recipient vessels.
Findings:
- Successful arterial and venous anastomoses were performed to the distal thoracodorsal artery and subscapular vein.
- No vein grafts were required.
- Flap survival and donor site integrity were maintained in all cases.
Implications:
- The reverse-flow scapular osteocutaneous flap is a safe and effective method for complex mandibular reconstruction.
- This technique is particularly valuable in patients with limited recipient vessels due to prior treatments.
- Demonstrates a viable reconstructive option for challenging head and neck cases.