Publication date: Available online 1 July 2017
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Sung Joon Park, Woo-Jin Jeong, Soon-Hyun Ahn
The purpose of this study was to propose a novel, minimally invasive trans-axillary approach for harvesting the scapular tip and latissimus dorsi osteomyogenous free flap for the reconstruction of a maxillectomy defect. A retrospective case series study of 4 patients who underwent reconstruction using a scapular tip compositefree flap via the trans-axillary approach was conducted. The data (age, sex, pathology, previous treatment, and adjuvant treatment) were collected and analysed. Total operation time, number of hospital days, and the cosmetic and functional outcome of reconstruction were analysed. Two male and two female patients were enrolled in this study. The patients’ ages ranged from 52 to 59 years. All the patients had maxillectomy defects, with at least a classification of Okay type II, that were successfully reconstructed using a scapular tip and latissimus dorsifree flap via a minimally invasive trans-axillary approach. The entire operation time for the primary tumour surgery and reconstruction ranged from 6.2 to 12.1 hours (mean, 11.1 hours). The average length of the hospital stay was 13 days (range, 10-16 days). No major donor site morbidity was observed and there was no graft failure which required revision or exploration surgery. The minimally invasive trans-axillary approach for harvesting the scapular tip and latissimus dorsi osteomyogenous free flap for the reconstruction of maxillectomy defect is a promising approach for more favourable functional and aesthetic outcomes when compared to the use of other bone containing free flaps and the classic approach for harvesting scapular tip and latissimus dorsi free flap.
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