Scapular Tip Free Flap for Head and Neck Reconstruction

Area of Science:

• Plastic Surgery
• Head and Neck Surgery
• Reconstructive Surgery

Background:

• Head and neck reconstruction presents significant challenges for achieving optimal esthetic and functional results.
• The scapular tip free flap (STFF) is a reconstructive option, but its feasibility using an angular branch-based approach requires further investigation.

Purpose of the Study:

• To evaluate the feasibility and outcomes of the angular branch-based scapular tip free flap (STFF) for head and neck reconstruction.
• To assess surgical, esthetic, and functional results following STFF in patients undergoing maxillectomy and mandibulectomy.

Main Methods:

• A retrospective study involving 17 patients who underwent maxillectomy and/or mandibulectomy reconstructed with STFF.
• Data collection included surgical details, flap characteristics (pedicle length, bone size), failure rates, esthetic outcomes (photographs), and functional assessments (CT scans).

Main Results:

• The angular branch-based STFF was successfully used in 17 patients (8 maxillary, 9 mandibular reconstructions) with a low flap failure rate of 5.9% (1/17).
• No vein grafting was required. Minor complications included orbital revisions for diplopia in 25% of maxillectomy patients and oroantral fistula repair in 12.5%.

Conclusions:

• The angular branch-based STFF offers significant reconstructive advantages, including a long pedicle, low failure rate, and excellent 3D chimeric tissue transfer.
• This flap is a valuable option for complex head and neck defects, with minimal donor site morbidity and preservation of ambulation.