Nayeon Choi1, Jae-Keun Cho2, Jeon Yeob Jang3, Jung Kyu Cho1, Young Sang Cho1, Chung-Hwan Baek1. 1. Department of Otorhinolaryngology-Head and Neck Surgery, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Department of Otorhinolaryngology-Head and Neck Surgery, Inje University Ilsan Paik Hospital, Inje University School of Medicine, Goyang, Korea. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Pusan National University Hospital, Busan, Korea.
Abstract
OBJECTIVES: Head and neck reconstruction is still challenging in terms of esthetic and functional outcomes. This study investigated the feasibility of the angular branch-based scapular tip free flap (STFF). METHODS: This was a retrospective study of 17 patients undergoing maxillectomy and mandibulectomy and either primary or secondary reconstruction by STFF. This study included surgical, esthetic, and functional outcomes, and detailed data are presented regarding the flap, such as pedicle length, size of the harvested bone, and failure rate. Medical photographs were used to estimate the esthetic outcome, and computed tomography was used to check the flap status postoperatively. RESULTS: The data were collected from April 2013 to April 2014. Eight patients underwent maxillary reconstruction, and nine underwent mandibular reconstruction. Maxillary defects usually included unilateral alveolar structures and the palate; mandibular defects were usually those involving mandibular angle and short segment. Vein grafting was not required in any of the patients. Flap failure occurred in one of the 17 patients (5.9%) with successful reconstruction after revision. Of the eight maxillectomy patients, orbital revisions for diplopia after maxillary reconstruction were performed in two patients (25%), and oroantral fistula repair was performed in one patient (12.5%). CONCLUSION: This study demonstrated the reconstructive advantages of the angular branch-based STFF, long pedicle, low flap failure, 3-dimensional nature of bone and soft tissues (chimeric flap), and small rate of donor site morbidity with free ambulation. This flap is an excellent option for use in complex three-dimensional head and neck reconstruction.
OBJECTIVES: Head and neck reconstruction is still challenging in terms of esthetic and functional outcomes. This study investigated the feasibility of the angular branch-based scapular tip free flap (STFF). METHODS: This was a retrospective study of 17 patients undergoing maxillectomy and mandibulectomy and either primary or secondary reconstruction by STFF. This study included surgical, esthetic, and functional outcomes, and detailed data are presented regarding the flap, such as pedicle length, size of the harvested bone, and failure rate. Medical photographs were used to estimate the esthetic outcome, and computed tomography was used to check the flap status postoperatively. RESULTS: The data were collected from April 2013 to April 2014. Eight patients underwent maxillary reconstruction, and nine underwent mandibular reconstruction. Maxillary defects usually included unilateral alveolar structures and the palate; mandibular defects were usually those involving mandibular angle and short segment. Vein grafting was not required in any of the patients. Flap failure occurred in one of the 17 patients (5.9%) with successful reconstruction after revision. Of the eight maxillectomy patients, orbital revisions for diplopia after maxillary reconstruction were performed in two patients (25%), and oroantral fistula repair was performed in one patient (12.5%). CONCLUSION: This study demonstrated the reconstructive advantages of the angular branch-based STFF, long pedicle, low flap failure, 3-dimensional nature of bone and soft tissues (chimeric flap), and small rate of donor site morbidity with free ambulation. This flap is an excellent option for use in complex three-dimensional head and neck reconstruction.
Entities:
Keywords:
Free Tissue Flaps; Head and Neck Neoplasms; Mandibular Reconstruction; Scapula
Authors: Johannes T M van Gemert; Robert J J van Es; Antoine J W P Rosenberg; Andries van der Bilt; Ron Koole; Ellen M Van Cann Journal: J Oral Maxillofac Surg Date: 2011-11-12 Impact factor: 1.895
Authors: Catherine T Haring; Emily J Marchiano; Jayne R Stevens; Kelly M Malloy; Keith A Casper; Mark E Prince; Steven B Chinn; Chaz L Stucken; Andrew J Rosko; Matthew E Spector Journal: Plast Aesthet Res Date: 2021-07-04
Authors: Jürgen Wallner; Marcus Rieder; Michael Schwaiger; Bernhard Remschmidt; Wolfgang Zemann; Mauro Pau Journal: J Clin Med Date: 2022-08-19 Impact factor: 4.964