title: Reconstruction of major full cheek defects with combined extensive pedicled supraclavicular fasciocutaneous island flaps and extended vertical lower trapezius island myocutaneous flaps after ablation of advanced oral cancer.
abstract: OBJECTIVE
  The present clinical study assessed the feasibility of extensive pedicled supraclavicular fasciocutaneous island flaps combined with extended vertical lower trapezius island myocutaneous flaps for large, full-thickness cheek defect reconstruction after ablative oral cancer surgery.
  
  
  METHODS
  A retrospective review of data from consecutive patients requiring extensive pedicled supraclavicular fasciocutaneous island flaps and the extended vertical lower trapezius island myocutaneous flap to provide both an inner and an outer lining for major full-thickness cheek defects after oncologic resection.
  
  
  RESULTS
  Eight patients had advanced oral squamous cell carcinoma. All patients had combined bone and extensive soft-tissue defects. The extensive pedicled supraclavicular fasciocutaneous island flap with a skin paddle measuring 10 × 8 cm to 14 × 10 cm and the extended vertical lower trapezius island myocutaneous flap with a skin paddle measuring 25 × 10 cm to 15 × 8 cm were used to reconstruct the major through-and-through defects. No major complications occurred in any patient. The patients were followed up for 6 to 20 months; 6 patients were living with no evidence of disease, 1 was living with disease, and 1 had died of local recurrence.
  
  
  CONCLUSIONS
  The combined use of the extensive pedicled supraclavicular fasciocutaneous island flap with an extended vertical lower trapezius island myocutaneous flap to reconstruct major through-and-through cheek soft defects is reliable and an excellent alternative to other pedicles, even microsurgical free flaps, for patients who have previously undergone radiotherapy and surgery of the head and neck.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Sun Yet-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China. drchen@vip.163.com
authors.forename: Wei-Liang
authors.initials: WL
authors.lastname: Chen
authors.forename: Zhao-Hui
authors.initials: ZH
authors.lastname: Yang
authors.forename: Da-Ming
authors.initials: DM
authors.lastname: Zhang
authors.forename: Zhi-Quan
authors.initials: ZQ
authors.lastname: Huang
authors.forename: Song
authors.initials: S
authors.lastname: Fan
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D002610:Cheek / Q000601:surgery*; D018572:Disease-Free Survival; D005205:Fascia / Q000637:transplantation*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000601:surgery*; D009062:Mouth Neoplasms / Q000601:surgery*; D018482:Muscle, Skeletal / Q000637:transplantation*; D009364:Neoplasm Recurrence, Local / Q000473:pathology / Q000601:surgery; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply; D015996:Survival Rate; D020858:Tissue and Organ Harvesting / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods