Maxillary Reconstruction With the Scapular Angle Osteomyogenous Free Flap

Abstract

This investigation indicates that the angular scapular flap has some advantages over other free-tissue transfer techniques for complex maxillary defect reconstruction. A considerable number (46%) of patients will experience some type of local complications after undergoing these challenging reconstructions, and many (41%) will require revision surgery. Postoperative fistula will often close spontaneously. Donor site morbidity is relatively low according to preliminary analysis.

Guide design in virtual planning for scapular tip free flap reconstruction

“…Exposure of the scapular subsystem and scapular tip has been described previously . Briefly, an axillary incision is made to expose the anterior border of the latissimus dorsi muscle.…”

“…The issue of pedicle length has been addressed with the technical modification which elongates the pedicle by using the angular branch off the thoracodorsal artery . This allows harvest of bone from the scapular tip and a significant length of lateral border . Finally, for novice surgeons, reconstructive design and execution can be challenging and time consuming due to unfamiliarity with the subscapular system.…”

Supine positioning for the subscapular system of flaps: A pictorial essay

“…The flap is quite versatile with a number of tissue variations possible, including the more recently popularized scapular tip harvest based on the angular artery for a longer vascular pedicle, avoiding a vein graft, while utilizing the teres major as myogenous mucosal coverage . Unlike other osseous flaps, the scapular bone can be cut in nonlinear shapes to customize the bone to the defect, which is extremely valuable, particularly when reconstructing midface defects . The bone is also easier to osteotomize than the fibula given that it is thinner and that there is a lower risk of injury to the vascular pedicle during this step.…”

Surgical treatment of severe or moderate axillary burn scar contracture with transverse island scapular flap and expanded transverse island scapular flap in adult and pediatric patients—A clinical experience of 15 cases

“…The scapular flap, pedicled by the circumflex scapular artery, first described by dos Santos in 1980 [8], was primarily reported to treat axillary burn scar contracture by Marlin Dimond [9] in 1983. The scapular flap was used in a variety of types [10][11][12][13][14][15].…”