Shouldering the load of mandible reconstruction: 81 cases of oromandibular reconstruction with the scapular tip free flap

Head Neck. 2019 Jan;41(1):30-36. doi: 10.1002/hed.25342. Epub 2018 Dec 4.

Abstract

Background: The scapular tip free flap (STFF) is becoming more popular for oromandibular reconstruction. This article reviewed the early and late outcomes in a larger series over 9 years.

Methods: We conducted a retrospective review of all consecutive patients who underwent oromandibular reconstruction using the STFF at London Health Sciences Centre. Demographic information, surgical data, and complications were collected and analyzed.

Results: From April 2008 to March 2017, 81 STFFs were performed in 80 patients. The average bony reconstruction measured 5.4 cm. Bone-only flaps were utilized in 24 cases (29.6%). Five cases (6.2%) required a single osteotomy. There were 3 (3.7%) flap failures. There were 7 plate extrusions and 11 cases of radiographic nonunion.

Conclusion: The STFF is a reliable option with acceptable early and long-term results. The STFF may be considered as a first line option especially for shorter bone defects or in conjunction with complex soft tissue requirements.

Keywords: free tissue flap; head and neck reconstruction; head and neck surgery; mandibular reconstruction; scapula.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Free Tissue Flaps*
  • Humans
  • Male
  • Mandibular Neoplasms / surgery
  • Mandibular Reconstruction / adverse effects
  • Mandibular Reconstruction / methods*
  • Middle Aged
  • Muscle, Skeletal / transplantation
  • Operative Time
  • Osteoradionecrosis / surgery
  • Postoperative Complications
  • Reoperation / statistics & numerical data
  • Retrospective Studies
  • Scapula / transplantation*
  • Young Adult