The osteocutaneous scapular flap for mandibular and maxillary reconstruction

Area of Science:

• Oral and Maxillofacial Surgery
• Plastic Surgery
• Reconstructive Surgery

Background:

• Reconstruction of maxillectomy and mandibular defects often requires robust bone and soft tissue.
• Previous methods have limitations in achieving optimal three-dimensional spatial relationships for complex defects.

Observation:

• Microfil injections in cadavers and clinical data from 26 patients confirm reliable vascularity of the scapular lateral border.
• Branches of the circumflex scapular artery reliably supply this region.

Findings:

• The lateral border of the scapula provides up to 14 cm of corticocancellous bone, suitable for osteotomy.
• Multiple cutaneous panels can be designed on a separate vascular pedicle from the bone flap.
• The thin scapular blade is ideal for palate and orbital floor reconstruction.

Implications:

• This scapular flap offers a versatile and reliable option for complex head and neck reconstructions.
• It allows for improved spatial arrangements in mandibular and maxillary reconstructions.
• The technique demonstrates a low complication rate with no flap failures.