Maxillary reconstruction using a bipedicled osteocutaneous scapula flap |
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| Authors: | I Yoshioka Y Yamashita A Khanal M Kodama T Takahashi K Tominaga |
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| Institution: | 1. Division of Oral Diagnostic and Surgical Science, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, 803-8580 Japan;2. Division of Oral and Maxillofacial Reconstructive Surgery, Department of Oral and Maxillofacial Surgery, Kyushu Dental College, Kitakyushu, 803-8580 Japan;1. Clinical Assistant Professor, Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea;2. Professor, Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea;3. Assistant Professor, Department of Anesthesiology and Pain Medicine, School of Medicine, Kyung Hee University, Seoul, Korea;4. Resident, Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea;6. Assistant Professor, Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, Seoul, Korea;1. Resident, Oral and Maxillofacial Surgery, Universidad El Bosque, Bogotá, Colombia;2. Senior Surgeon, Division of Oral and Maxillofacial Surgery, Clínica Infantil Colsubsidio and Assistant Professor, Department of Oral and Maxillofacial Surgery, Universidad El Bosque, Bogotá, Colombia;1. Resident, Clinic for Craniomaxillofacial Surgery, University Hospital, Zurich, Switzerland;2. Fellow, Clinic for Craniomaxillofacial Surgery, University Hospital, Zurich, Switzerland;3. Fellow, Clinic for Craniomaxillofacial Surgery, University Hospital, Zurich, Switzerland;4. Adjunct Professor, Department of Biostatistics, Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland;6. Professor and Medical Director, Clinic for Craniomaxillofacial Surgery, University Hospital, Zurich, Switzerland;5. Fellow, Clinic for Craniomaxillofacial Surgery, University Hospital, Zurich, Switzerland |
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| Abstract: | When managing extensive maxillary defects it is difficult to provide a stable biomechanical frame for prostheses, and obturators are difficult to use. This study reviews cases involving angular branch artery pedicled scapular bone flaps (SBF) combined with or without latissimus dorsi musculocutaneous flap (LDMF). Between 2004 and 2007, four wide maxillary defects were repaired using the angular vascularized branch of the scapular bone. Tumor resection with immediate reconstruction using combined LDMF and angular artery pedicled SBF was used in 3 cases and angular artery pedicled SBF alone in 1 case. Follow up was 6 months to 2 years. Satisfactory results were obtained for facial contour, appearance, speech, deglutition and breathing. No donor site complications or restricted shoulder movements were detected. The only complication was a minor infection of one flap. This procedure is useful, functionally and aesthetically, for reconstruction of wide extensive maxillary defects as bone supplied by the angular branch has a wider arc of rotation in relation to skin flaps and has a longer pedicle length from the axillary artery, long enough to reach the maxilla. This procedure also benefits from the flexibility of the soft tissue pedicle, such as the latissimus dorsi, serratus anterior and fasciocutaneous flaps. |
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