Scapular osteocutaneous free flap for total lower lip and mandible reconstruction

Abstract

This single-flap approach may provide an alternative to dual free flap reconstruction of total lower lip and mandible. © 2016 Wiley Periodicals, Inc. Microsurgery 36:480-484, 2016.

One stage microvascular mandible reconstruction by using scapula chimeric flap combined with computer‐aided‐design and computer‐aided‐manufacturing plate including bilateral alloplastic TMJ prosthesis: A case report

“…Harvesting scapula is an excellent alternative when bony reconstruction if a free fibular flap is not possible, for example, due to peripheral vascular disease (Blumberg et al, 2019). It offers abundant soft tissue availability and flexibility that allows intraoral and external coverage in cases of soft tissue deficiency, as well as versatile bone that can be manipulated by osteotomy to redraw the mandible (Dowthwaite et al, 2013; Jacobson et al, 2016). Moreover, it has several advantages, including less atherosclerosis of the vessels compared with lower extremity vessels (Blumberg et al, 2019; Urken, Bridger, Zur, & Genden, 2001), lengthy pedicle for anastomosis (Dowthwaite et al, 2013), low donor site morbidity (Clark et al, 2007), superior skin color match, and the ability to ambulate unimpeded early in the postoperative course (Blumberg et al, 2019).…”

“…Mandibular reconstruction after osteoradionecrosis (ORN) presents a complex challenge for reconstructive surgeons in restoring functional deficits and esthetic. Surgical correction must include external skin and intraoral mucosal coverage as well as a bony restoration (Jacobson, Dedhia, Kokot, & Chalian, 2016).…”

Total Lower Face Reconstruction with Double Free Flaps

“…1. One flap versus two flaps strategy: An alternative solution will be to do a chimeric flap from the subscapular system (Jacobson et al 2016) including two skin islands (TDAP plus Scapular/parascapular flaps) plus Bone flaps (scapula or extended scapula tip). The use of a fibula with two skin islands alone will not be a good option due to the donor site defect.…”

Total Lower Lip Reconstruction with Innervated Radial Forearm Flap and Palmaris Longus Tendon

“…1 Preoperative image of the defect showing a fullthickness total lower lip loss with exposure of the lower gingiva and dentition and deficiency of part of the right upper lip and angulus oris. The scarring following debridements reaches the mentum, and the labiomental sulcus is completely missing fibula flap (Jeng et al 2005) or scapula flap (Jacobson et al 2016) can be integrated in the reconstructive strategy.…”