Scapular angle osteomyogenous flap in postmaxillectomy reconstruction: Defect, reconstruction, shoulder function, and harvest technique

被引:130
作者
Clark, Jonathan R. [1 ,2 ,3 ]
Vesely, Martin [1 ,2 ]
Gilbert, Ralph [1 ,2 ]
机构
[1] Princess Margaret Hosp, Dept Otolaryngol Head & Neck Surg, Toronto, ON M4X 1K9, Canada
[2] Princess Margaret Hosp, Dept Plast Surg, Toronto, ON M4X 1K9, Canada
[3] Sydney Head & Neck Canc Inst, Sydney, NSW, Australia
来源
HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK | 2008年 / 30卷 / 01期
关键词
scapular angle; scapular tip; free flap; maxillectomy; infrastructure; midface; reconstruction;
D O I
10.1002/hed.20649
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 [耳鼻咽喉科学];
摘要
Background. Maxillary reconstruction continues to challenge in terms of optimal aesthetic and functional outcomes. The aim of this study was to describe the utility of the scapular angle osteomyogenous flap in a series of maxillectomy patients and to examine the donor site morbidity. Methods. This is a retrospective series of 14 patients undergoing maxillectomy and either primary or secondary reconstruction. The scapular angle can be oriented vertically and horizontally. Aesthetic, functional, and operative morbidity is described. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to examine shoulder and upper limb morbidity. Results. Perioperative morbidity occurred in 4 patients. There were no free flap failures. Functional and aesthetic outcomes were acceptable with all patients having intelligible speech and none requiring nutritional supplementation. The DASH was completed by 12 of 14 patients. The mean and median DASH scores were 10.6 and 13, respectively. All patients gained full range of shoulder movement by 6 months after surgery. Conclusions. The scapular angle flap is well suited for maxillary reconstruction and donor site morbidity is low. (c) 2007 Wiley Periodicals, Inc.
引用
收藏
页码:10 / 20
页数:11
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