title: Scapular free flap harvest site: recognising the spectrum of radiographic post-operative appearance.
abstract: OBJECTIVE
  Scapular free flap harvesting for oral cavity cancer reconstruction is an increasingly used and versatile option. We aim to describe the appearance of the scapula harvest site on chest radiograph and CT.
  
  
  METHODS
  We retrospectively reviewed a surgical database of 82 patients who underwent scapular osteocutaneous flap harvesting for oral cavity cancer reconstruction and had imaging performed at our institution. We searched the picture archiving and communications system for all associated imaging.
  
  
  RESULTS
  Characteristic radiographic appearance in the immediate post-operative period as well as in the remote post-operative period is described, including an upside-down V-shaped paraglenoid notch, rectangular (or triangular) lateral border defects and a sharply pointed inferior scapular body. Additionally, common CT appearances are discussed, including an abrupt gleno-scapular interval, an absent axillary rim bulge and a Z-shaped scapula.
  
  
  CONCLUSIONS
  The altered appearance of the scapular defect following surgical harvest is easily recognised. Although the description of this defect may not alter management and may reasonably be omitted, a radiologist's comfort with these appearances may potentially enhance the understanding of patient management and recognition of superimposed complications, such as infection.
  
  
  CONCLUSIONS
  Scapular osteocutaneous free flap reconstruction is an increasingly used technique after oral cavity surgery. Very few radiologists reported in our review the surgical scapular defects, and there is apparent ignorance of their appearance. We described characteristic radiographic and CT signs of scapular free flap harvesting to increase radiologists' familiarity with these defects, which may provide clinical information and possibly contribute to detection of complications.
authors: Department of Radiology, Beth Israel Medical Center, New York, NY, USA. dpowell@chpnet.org
authors: D K
authors: DK
authors: Powell
authors: F
authors: F
authors: Nwoke
authors: M L
authors: ML
authors: Urken
authors: D
authors: D
authors: Buchbinder
authors: A S
authors: AS
authors: Jacobson
authors: J E
authors: JE
authors: Silberzweig
authors: A S
authors: AS
authors: Khorsandi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D007571:Jaw Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D010025:Osteoradionecrosis / Q000601:surgery; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D012540:Scapula / Q000000981:diagnostic imaging*; D020858:Tissue and Organ Harvesting / Q000379:methods*; D014057:Tomography, X-Ray Computed; D060053:Transplant Donor Site / Q000000981:diagnostic imaging*; D055815:Young Adult
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