Shoulder flap for head and neck reconstruction: an alternative when everything else fails

The use of axial and free flaps made the use of delayed random flaps for the reconstruction of the head and neck almost obsolete. Immediate reconstruction of intraoral defects using the pectoralis major musculocutaneous flap primarily, as well as other axial or free flaps, has become a common practice. However, in some selected cases due to failure of previous operations or complications of radiation and recurrence, the reconstructive surgeon is left with very little choice. The purpose of this paper is not to advocate the use of the shoulder flap as a primary reconstructive procedure, but to call attention to its availability for certain complicated cases and briefly described the details of the technique.