Maxillary reconstruction with scapular tip chimeric free flap

Abstract

Purpose Purpose of the article is to discuss the use of the scapular tip free flap (STFF) for the reconstruction of maxillary defects. Methods A retrospective evaluation of patients who underwent maxillary reconstruction with STFF is presented. Patients were evaluated with respect to complications, function, and cosmesis. Results Study population consisted of 53 patients. All flaps survived and partial bone resorption only occurred in a young patient. Minor complications included two instances of partial muscular necrosis. The donor site was primarily closed in all patients. Mouth opening was assessed as good (>3 cm) in 41 patients, partially limited (2–3 cm) in 9 patients, and limited (<2 cm) in 3 patients. Dental rehabilitation was achieved in 35 patients; esthetic results were assessed by patient as excellent in 19 patients, good in 28 patients, and poor in 6 patients. Conclusions The scapular tip chimeric free flap represents an indispensable tool for reconstructive head and neck microsurgery. The main advantages of this technique are very low donor site morbidity and a long pedicle, as well as the potential for harvesting multiple flaps in a chimeric design; STFF represents the first choice for treatment of small postero‐lateral defects of the maxilla, and of wide and complex through‐and‐through defects involving all components of the midface.

Near‐total mandibular reconstruction following osteoradionecrosis with double scapula tip free flap: A case report

“…They reported on both minimal perioperative and long term morbidity in patients after undergoing STFF reconstruction. Post-operative time to ambulation was between 2 and 4 days, and long term shoulder function impairment was minimal, with the authors reinforcing the low morbidity associated with harvesting the STFF (Ferri et al, 2021). Due to these advantages, the STFF has become the preferred flap for osseous reconstruction of segmental mandibular defects at our institution, being favored over the osteocutaneous radial forearm, fibula, and the iliac crest.…”

Donor Site Morbidity and Quality of Life after Microvascular Head and Neck Reconstruction with a Chimeric, Thoracodorsal, Perforator-Scapular Flap Based on the Angular Artery (TDAP-Scap-aa Flap)

“…Due to this limitation, several research groups stated that further investigations regarding an objective evaluation of postoperative donor site morbidity after scapular free flap harvesting should be conducted [ 2 , 19 , 22 ]. In 2021, Ferri et al, underpinned the previous assumptions of low donor site morbidity by presenting a series of 19 patients [ 26 ].…”

Anterolateral thigh osteomyocutaneous flap in head and neck: Lessons learned

“…In a recent report by Ferri et al, (2021), the authors describe the advantages of the scapular tip free flap (STFF) in head and neck defects requiring reconstruction of multiple components including skin, muscle, and bone. Based on the thoracodorsal vessels and their chimeric variations including latissimus dorsi and/or serratus muscle, the STFF provides a long pedicle that is traditionally spared from atherosclerotic disease and with minimal morbidity associated with harvest (Ferri et al, 2021; Piazza et al, 2013). The donor site is closed primarily with minimal pain and impairment of shoulder function postoperatively (Ferri et al, 2021).…”

“…Based on the thoracodorsal vessels and their chimeric variations including latissimus dorsi and/or serratus muscle, the STFF provides a long pedicle that is traditionally spared from atherosclerotic disease and with minimal morbidity associated with harvest (Ferri et al, 2021; Piazza et al, 2013). The donor site is closed primarily with minimal pain and impairment of shoulder function postoperatively (Ferri et al, 2021). Significant limitations of the STFF however are encountered in reconstructions requiring greater than 8 cm of bone and/or dental rehabilitation with implants.…”