The Scapular Osteofasciocutaneous Flap
A 12-Year Experience
Mark L. Urken, MD;
Andrew G. Bridger, MD;
Karen B. Zur, MD;
Eric M. Genden, MD
Arch Otolaryngol Head Neck Surg. 2001;127:862-869.
Objective To elucidate the factors that play a role in the decision-making process
to use the scapular donor site, we have reviewed our 15-year experience with
57 clinical cases, to our knowledge the largest case series to date.
Design Retrospective, single-surgeon medical record review.
Patients and Methods Retrospective review of 57 consecutive cases (53 patients) involving
mandibular and maxillary reconstruction using bone-containing scapular free
flaps over a 15-year period. Composite flap composition as well as donor and
recipient site complications were recorded.
Results Forty-one reconstructions were performed for mandibular defects, 11
were performed for maxillary defects, and 5 for combined defects involving
the mandible and maxilla. Seven flaps were composed of 2 separate bone flaps
using the angular branch and the circumflex scapular artery. A total of 6
flaps were failures in 5 patients, giving an overall success rate of 89%.
Conclusions The subscapular system of flaps is a versatile donor site that offers
distinct advantages in the older patient population as well as in patients
with a preexisting gait disturbance. It is particularly advantageous in patients
requiring a large surface area of soft tissue to restore their defect.
From the Department of Otolaryngology–Head and Neck Surgery,
Mount Sinai Medical Center, New York, NY.
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