Supraclavicular Artery Flap for Head and Neck Oncologic Reconstruction: An Emerging Alternative

Abstract

Aim. Head and Neck oncologic resections often leave complex defects which are challenging to reconstruct. The need of the hour is a versatile flap which has the advantages of both a regional flap (viz. reliable and easy to harvest) and a free flap (thin, pliable with good colour match). In this a study we assessed the usefulness of the supraclavicular artery flap in head and neck oncologic defects. Materials and Method. The flap was used as a pedicled fasciocutanous and was based on the transverse supraclavicular artery. We assessed this reconstructive option for complications as well as its and functional out comes. Results. Eleven cases underwent supraclavicular artery flap between 20011-2012 of which 5 were males and 6 females. Mean defect size was 5 cm × 6 cm. Nine donor sites were closed primarily and 1 required split skin grafting. We encountered one complete flap loss which was attributed to a band of constricting skin bridge over the vascular pedicle in a defect involving lateral third of midface. Two patient developed pharyngeocutaneous fistula (without flap loss) out of 3 patients who underwent augmentation pharyngoplasty post Near total laryngectomy. Conclusion. Supra clavicular artery flap is a thin versatile, reliable, easy to harvest, with good cosmetic and functional outcome at both ends (recipient and donor) for reconstructing head and neck oncologic defects.

Taking a step down on the reconstruction ladder for head and neck reconstruction during the COVID-19 pandemic

“…The supraclavicular artery flap provides large thin fascio-cutaneous coverage to most of the defects of the head and neck region [ 49 ]. This flap is easy to harvest and a good colour match if used for skin defects [ 50 ]. Super-charge of flap can be done if a large size flap is needed [ 51 ].…”

Technique of neo-pharynx reconstruction with supra-clavicular artery island flap in a case of pharyngeal stricture

“…17 Although unilateral SCAIF has already been used in repair of similar defects of smaller dimensions, here we discuss the case where SCAIF is being used for closure of a circumferential pharyngeal defect after resection of the long stricture segment. 17,18 SCAIF is easily accessible, can be harvested quickly thereby decreasing the operating time significantly. The thin pedicle allows tunneling of the island flap into the defect with considerable ease in the head and neck region and offers a loco regional flap…”

Supraclavicular flap practice patterns and outcomes: A survey of 221 AHNS surgeons

“…Single‐institution studies have described reconstruction of oral (i.e., tongue, lip, buccal, palatal, mandibular), facial (i.e., nasal, periorbital, orbital, auriculotemporal), laryngeal, pharyngeal, esophageal, tracheal, posterolateral skull base, neck, and chest wall defects using the SCF . Various authors champion differences in preoperative Doppler use, harvest location, pedicle skeletonization, and suitable defect sites for reconstruction . These SCF practice patterns have yet to be characterized.…”

“…[4][5][6][7] Various authors champion differences in preoperative Doppler use, harvest location, pedicle skeletonization, and suitable defect sites for reconstruction. 3,4,[8][9][10][11][12] These SCF practice patterns have yet to be characterized. Furthermore, SCF outcomes have varied substantially by study.…”