Abstract
Subscapular system free flaps for oromandibular reconstruction
Highlights
Oromandibular defects are among the most complex in head and neck reconstruction
The iliac crest, fibula free flap, osteocutaneous radial forearm flap (OCRFF), and scapular free flaps have all emerged as potential donor sites for mandibular reconstruction[3]
Its usage in oromandibular reconstruction has been limited by a bulky skin paddle, resultant gait disturbance, potential for incisional hernia, inability to perform shaping osteotomies, injury to the lateral femoral cutaneous nerve, and susceptibility toward wound complications[4]
Summary
Oromandibular defects are among the most complex in head and neck reconstruction. The integrity of the oromandibular complex is essential for optimal function of swallow, speech, and breathing. The fibula free flap is characterized by its sufficient cortical bone stock, ample bone and pedicle length, thin pliable skin paddle, and ease of two-team harvest. It has emerged as the predominant workhorse flap in mandibular reconstruction. The subscapular system offers a versatile selection of flaps that have been well-described and lauded for its ability to reconstruct complex three-dimensional defects This system offers three potential skin paddles, two muscle flaps, and three sources of bone, with the potential for conjoined or chimeric variations allowing for significant reconstructive flexibility[5,6]. Successful use of the latissimus dorsi-serratus-rib complex in mandibular reconstruction has been described as a salvage osseous option[4]
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