Scapular and Parascapular Free Tissue Transfer Workup

  • Author: Jason H Kim, MD; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Dec 1, 2011
 

Imaging Studies

Imaging and vascular studies are not indicated in the preoperative assessment. However, if atherosclerotic disease or the caliber of the arteries is a concern, angiography can assist in the evaluation. However, this is rare.

Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

Jason H Kim, MD  Associate Professor, Department of Otolaryngology-Head and Neck Surgery, University of California at Irvine

Jason H Kim, MD, is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, and American Medical Association

Disclosure: Nothing to disclose.

Specialty Editor Board

John C Li, MD  Private Practice in Otology and Neurotology; Medical Director, Balance Center

John C Li, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Neurotology Society, American Tinnitus Association, Florida Medical Association, and North American Skull Base Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Dominique Dorion, MD, MSc, FRCSC, FACS  Vice Dean and Associate Dean of Resources, Professor of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of Sherbrooke Faculty of Medicine, Canada

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

Additional Contributors

The authors and editors of eMedicine gratefully acknowledge the contributions of previous author Derrick Wallace, MD, to the development and writing of this article.

References

  1. Saijo M. The vascular territories of the dorsal trunk: a reappraisal for potential flap donor sites. Br J Plast Surg. Jul 1978;31(3):200-4. [Medline].

  2. dos Santos LF. Retalmo circulare: un novo retalmo livre microcirurgico. Rev Bras Cir. 1980;70:133-7.

  3. dos Santos LF. The vascular anatomy and dissection of the free scapular flap. Plast Reconstr Surg. Apr 1984;73(4):599-604. [Medline].

  4. Teot L, Bosse JP, Moufarrege R. The scapular crest pedicle bone graft. Int J Microsurg. 1981;3:257-262.

  5. Swartz WM, Banis JC, Newton ED, et al. The osteocutaneous scapular flap for mandibular and maxillary reconstruction. Plast Reconstr Surg. Apr 1986;77(4):530-45. [Medline].

  6. Coleman JJ 3rd, Sultan MR. The bipedicled osteocutaneous scapula flap: a new subscapular system free flap. Plast Reconstr Surg. Apr 1991;87(4):682-92. [Medline].

  7. Batchelor AG, Sully L. A multiple territory free tissue transfer for reconstruction of a large scalp defect. Br J Plast Surg. Jan 1984;37(1):76-9. [Medline].

  8. Frodel JL Jr, Funk GF, Capper DT, et al. Osseointegrated implants: a comparative study of bone thickness in four vascularized bone flaps. Plast Reconstr Surg. Sep 1993;92(3):449-55; discussion 456-8. [Medline].

  9. Moscoso JF, Keller J, Genden E, et al. Vascularized bone flaps in oromandibular reconstruction. A comparative anatomic study of bone stock from various donor sites to assess suitability for enosseous dental implants. Arch Otolaryngol Head Neck Surg. Jan 1994;120(1):36-43. [Medline].

  10. Janus JR, Carlson ML, Moore EJ. The scapular, parascapular, and latissimus dorsi flap as a single osteomyocutaneous flap for repair of complex oral defects. Clin Anat. Sep 13 2011;[Medline].

  11. Tanna N, Wan DC, Kawamoto HK, Bradley JP. Craniofacial microsomia soft-tissue reconstruction comparison: inframammary extended circumflex scapular flap versus serial fat grafting. Plast Reconstr Surg. Feb 2011;127(2):802-11. [Medline].

  12. Miles BA, Gilbert RW. Maxillary reconstruction with the scapular angle osteomyogenous free flap. Arch Otolaryngol Head Neck Surg. Nov 2011;137(11):1130-5. [Medline].

  13. Fairbanks GA, Hallock GG. Facial reconstruction using a combined flap of the subscapular axis simultaneously including separate medial and lateral scapular vascularized bone grafts. Ann Plast Surg. Jul 2002;49(1):104-8; discussion 108. [Medline].

  14. Gilbert A, Teot L. The free scapular flap. Plast Reconstr Surg. Apr 1982;69(4):601-4. [Medline].

  15. Nassif TM, Vidal L, Bovet JL, et al. The parascapular flap: a new cutaneous microsurgical free flap. Plast Reconstr Surg. Apr 1982;69(4):591-600. [Medline].

  16. Seitz A, Papp S, Papp C, et al. The anatomy of the angular branch of the thoracodorsal artery. Cells Tissues Organs. 1999;164(4):227-36. [Medline].

  17. Kim PS, Gottlieb JR, Harris GD, et al. The dorsal thoracic fascia: anatomic significance with clinical applications in reconstructive microsurgery. Plast Reconstr Surg. Jan 1987;79(1):72-80. [Medline].

  18. Urken ML, Bridger AG, Zur KB, et al. The scapular osteofasciocutaneous flap: a 12-year experience. Arch Otolaryngol Head Neck Surg. Jul 2001;127(7):862-9. [Medline].

  19. Quillen CG. Latissimus dorsi myocutaneous flaps in head and neck reconstruction. Plast Reconstr Surg. May 1979;63(5):664-70. [Medline].

  20. Barton FE Jr, Spicer TE, Byrd HS. Head and neck reconstruction with the latissimus dorsi myocutaneous flap: anatomic observations and report of 60 cases. Plast Reconstr Surg. Feb 1983;71(2):199-204. [Medline].

  21. Sullivan MJ, Baker SR, Crompton R, et al. Free scapular osteocutaneous flap for mandibular reconstruction. Arch Otolaryngol Head Neck Surg. Nov 1989;115(11):1334-40. [Medline].

  22. Coleman SC, Burkey BB, Day TA, et al. Increasing use of the scapula osteocutaneous free flap. Laryngoscope. Sep 2000;110(9):1419-24. [Medline].

  23. Ang E, Black C, Irish J, et al. Reconstructive options in the treatment of osteoradionecrosis of the craniomaxillofacial skeleton. Br J Plast Surg. Mar 2003;56(2):92-9. [Medline].

  24. Chang DW, Oh HK, Robb GL, et al. Management of advanced mandibular osteoradionecrosis with free flap reconstruction. Head Neck. Oct 2001;23(10):830-5. [Medline].

  25. Germain MA, Hartl DM, Marandas P, et al. Free flap reconstruction in the treatment of tumors involving the hard palate. Eur J Surg Oncol. Apr 2006;32(3):335-9. [Medline].

  26. Kakibuchi M, Fujikawa M, Hosokawa K, et al. Functional reconstruction of maxilla with free latissimus dorsi-scapular osteomusculocutaneous flap. Plast Reconstr Surg. Apr 1 2002;109(4):1238-44; discussion 1245. [Medline].

  27. Malikov S, Casanova D, Magnan PE, et al. Anatomical bases of the bypass-flap: study of the thoracodorsal axis. Surg Radiol Anat. Apr 2005;27(2):86-93. [Medline].

  28. Mehta RP, Deschler DG. Mandibular reconstruction in 2004: an analysis of different techniques. Curr Opin Otolaryngol Head Neck Surg. Aug 2004;12(4):288-93. [Medline].

  29. Militsakh ON, Werle A, Mohyuddin N, et al. Comparison of radial forearm with fibula and scapula osteocutaneous free flaps for oromandibular reconstruction. Arch Otolaryngol Head Neck Surg. Jul 2005;131(7):571-5. [Medline].

  30. Niitsuma K, Hatoko M, Kuwahara M, et al. Successful free osteocutaneous scapular flap transfer for mandibular reconstruction in a 93-year-old patient. J Craniofac Surg. Jan 2004;15(1):92-7. [Medline].

  31. Rinaldo A, Shaha AR, Wei WI, et al. Microvascular free flaps: a major advance in head and neck reconstruction. Acta Otolaryngol. Oct 2002;122(7):779-84. [Medline].

  32. Takushima A, Harii K, Asato H, et al. Choice of osseous and osteocutaneous flaps for mandibular reconstruction. Int J Clin Oncol. Aug 2005;10(4):234-42. [Medline].

 
Previous
Next
 
Composite defect that involves the mandible and oral tongue.
Design of the scapula osteocutaneous free flap. An external Doppler was used to mark the horizontal and vertical segments of the vessel.
The circumflex scapular and thoracodorsal vascular system.
Scapular bone and skin harvested.
Reconstruction of the composite defect with scapular osteocutaneous flap.
Large through-and-through defect of the mandible, oral mucosa, and external skin.
Insetting of the tissue.
Defect reconstructed with the scapular free flap.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.