Maxillofac Plast Reconstr Surg.  2018 ;40(1):25. 10.1186/s40902-018-0165-1.

The supraclavicular artery island flap: a salvage option for head and neck reconstruction

• Lee S
• Cho HM
• Kim JK
• Nam W

• KMID: 2431948
• DOI: http://doi.org/10.1186/s40902-018-0165-1

Abstract

BACKGROUND
Some of head and neck cancer patients are in compromised general condition after ablation surgery and chemoradiation therapy, which makes secondary free tissue transfer quite challenging. Elderly cancer patients also have some risk for microvascular surgery with lengthened general anesthesia. In those cases, the pedicled flap vascularized by supraclavicular artery could be considered as an alternative to free flap. Despite several authors have demonstrated the clinical reliability of supraclavicular artery island flap (SCAIF), to date, SCAIF has not been widely used among reconstructive surgeon. In this article, we clarified vascular flow pattern and introduce simple surgical technique of SCAIF with a literature review.
CASE PRESENTATION
Three patients who had underwent previous neck surgery and adjuvant therapy received maxillofacial reconstruction using SCAIF. It required only a few landmarks, flap harvesting was carried out, and the elapsed time gradually decreased to 15 min with experiences. There were no remarkable morbidities in both donor and recipient sites.
CONCLUSION
SCAIF exhibited minimal anatomic variations and short learning curve of surgical techniques, which might be valuable reconstruction modality for beginning surgeon. And it can be beneficial option for the patients with vessel-depleted neck, medically compromised status for lengthened general anesthesia and failed free tissue transfer.

Keyword

Mandibular reconstructive surgery; Cervicoplasty; Pedicled flap; Head and neck neoplasm; Osteoradionecrosis

MeSH Terms

Aged
Anesthesia, General
Arteries*
Cervicoplasty
Free Tissue Flaps
Head and Neck Neoplasms
Head*
Humans
Learning Curve
Mandibular Reconstruction
Neck*
Osteoradionecrosis
Surgical Flaps
Tissue Donors