Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: contrasting shoulder morbities across mysofascial flaps

Abstract

Revisiting pedicled latissimus dorsi flaps in head and neck reconstruction: contrasting shoulder morbities across mysofascial flaps.

Osteotomized folded scapular tip free flap for complex midfacial reconstruction

“…Free flaps based on the subscapular arterial system provide the most versatile of the osseous flaps given the option for separate segments of bone, multiple skin paddles, and significant volume to fill the defect. The scapular tip-free flap from the angular artery provides a long pedicle length and has morphologic similarity to the palate [8] . Case series at multiple institutions have indicated that osteotomies and dental implants can be used successfully in scapular tip-free flaps for mandibular reconstruction, although there is limited data on these techniques in maxillary reconstruction [6,20,21] .…”

“…The radial forearm, fibula, iliac crest, and scapula osteocutaneous free flap have been described for use in boney reconstruction of maxillary defects [2,4] . Previous studies have demonstrated the utility of the scapula tip for midfacial reconstruction [5][6][7][8] . The scapula tip-free flap has advantages over the fibula or iliac crest related to the chimeric nature of the subscapular vascular system allowing for multiple tissue types, long vascular pedicle, ability to perform extirpation and flap harvest concurrently, acceptable donor site morbidity, and excellent versatility in rebuilding 3-dimentional bone structures of the craniofacial skeleton [5,6,8,9] .…”

“…Previous studies have demonstrated the utility of the scapula tip for midfacial reconstruction [5][6][7][8] . The scapula tip-free flap has advantages over the fibula or iliac crest related to the chimeric nature of the subscapular vascular system allowing for multiple tissue types, long vascular pedicle, ability to perform extirpation and flap harvest concurrently, acceptable donor site morbidity, and excellent versatility in rebuilding 3-dimentional bone structures of the craniofacial skeleton [5,6,8,9] . The scapula tip can be placed horizontally to reconstruct the palatoalveolar complex or vertically to restore the zygomaticomaxillary and nasomaxillary buttresses [8,10] .…”

“…The scapula tip-free flap has advantages over the fibula or iliac crest related to the chimeric nature of the subscapular vascular system allowing for multiple tissue types, long vascular pedicle, ability to perform extirpation and flap harvest concurrently, acceptable donor site morbidity, and excellent versatility in rebuilding 3-dimentional bone structures of the craniofacial skeleton [5,6,8,9] . The scapula tip can be placed horizontally to reconstruct the palatoalveolar complex or vertically to restore the zygomaticomaxillary and nasomaxillary buttresses [8,10] . However, some authors report difficulty orienting the scapula tip bone to simultaneously reconstruct the vertical and horizontal buttresses in complex maxillary defects.…”

Lateral border and scapular tip free flaps: Old school versus new school

“…8 However, current positioning systems allow for two team approaches to the harvest of both LSBFF and STFF. 9,10 The following pictorial essay describes the positioning pearls, operative technique, and clinical considerations for each of these free flaps. Institutional approval for this study was provided through the University of Michigan with informed consent obtained from all depicted patients.…”