title: Scapular angle osteomyogenous flap in postmaxillectomy reconstruction: defect, reconstruction, shoulder function, and harvest technique.
abstract: BACKGROUND
  Maxillary reconstruction continues to challenge in terms of optimal aesthetic and functional outcomes. The aim of this study was to describe the utility of the scapular angle osteomyogenous flap in a series of maxillectomy patients and to examine the donor site morbidity.
  
  
  METHODS
  This is a retrospective series of 14 patients undergoing maxillectomy and either primary or secondary reconstruction. The scapular angle can be oriented vertically and horizontally. Aesthetic, functional, and operative morbidity is described. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire was used to examine shoulder and upper limb morbidity.
  
  
  RESULTS
  Perioperative morbidity occurred in 4 patients. There were no free flap failures. Functional and aesthetic outcomes were acceptable with all patients having intelligible speech and none requiring nutritional supplementation. The DASH was completed by 12 of 14 patients. The mean and median DASH scores were 10.6 and 13, respectively. All patients gained full range of shoulder movement by 6 months after surgery.
  
  
  CONCLUSIONS
  The scapular angle flap is well suited for maxillary reconstruction and donor site morbidity is low.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Princess Margaret Hospital, Toronto, Canada.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
authors.forename: Martin
authors.initials: M
authors.lastname: Vesely
authors.forename: Ralph
authors.initials: R
authors.lastname: Gilbert
mesh_terms: D000368:Aged; D000564:Ameloblastoma / Q000601:surgery; D003528:Carcinoma, Adenoid Cystic / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D004185:Disability Evaluation; D004954:Esthetics; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000637:transplantation; D016059:Range of Motion, Articular / Q000502:physiology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012540:Scapula / Q000637:transplantation; D012782:Shoulder / Q000502:physiology; D013065:Speech Intelligibility; D013524:Surgical Flaps