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Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Evolution of complex palatomaxillary reconstructions: the scapular angle osteomuscular free flap
Cesare Piazza1, Alberto Paderno, Valentina Taglietti
1Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Brescia, Italy. ceceplaza@libero.it
Current Opinion in Otolaryngology & Head and Neck Surgery
|February 7, 2013
Summary
The angular branch-based scapular free flap offers a versatile solution for palatomaxillary reconstruction, showing favorable outcomes compared to other techniques for oncologic defects.
Area of Science:
- Oral and Maxillofacial Surgery
- Plastic Surgery
- Oncologic Reconstruction
Background:
- Palatomaxillary defects pose significant reconstructive challenges following oncologic surgery.
- Traditional osseous donor sites like the fibula and iliac crest have limitations.
Purpose of the Study:
- To review worldwide experience with the angular branch-based subscapular system for palatomaxillary reconstruction.
- To compare its advantages and disadvantages against other donor sites.
Main Methods:
- Review of 105 patient cases involving primary and secondary palatomaxillary reconstruction.
- Analysis of defect classifications and reconstruction techniques.
Main Results:
- Angular branch-based flaps are indicated for Okay class II and III defects, including orbital content removal.
- Flap harvesting can be performed in a supine position, overcoming previous drawbacks.
- The scapular tip's morphology facilitates flap design and adaptation to maxillary structures.
Conclusions:
- Angular branch-based osteomuscular scapular free flaps are a significant advancement in palatomaxillary reconstruction.
- They offer versatility, long pedicles, favorable morphology, and low donor-site morbidity.
- This technique favorably compares with other free flap options for complex reconstructions.