title: Supraclavicular artery island flap for reconstruction of complex parotidectomy, lateral skull base, and total auriculectomy defects.
abstract: OBJECTIVE
  There are limited data on the use of the supraclavicular artery island flap (SCAIF) for parotid and lateral skull base (LSB) surgery. This flap can be an important reconstructive tool for these procedures.
  
  
  OBJECTIVE
  To describe the use of the SCAIF for parotid and LSB surgery and its success, as well as important technique modifications for successful use of the flap in this setting.
  
  
  METHODS
  Retrospective single-institution review from July 1, 2011, to September 30, 2013, of patients in a tertiary care referral center. A prospectively collected institutional database was reviewed to identify patients who received SCAIF reconstruction for parotid and/or LSB surgery. Forty-six SCAIF reconstructions were identified; 16 were performed for the indication of parotidectomy or LSB surgery.
  
  
  METHODS
  The SCAIF reconstruction for parotid and/or LSB surgery.
  
  
  METHODS
  Indication for reconstruction, flap viability, flap size, reconstruction site complication, and donor site complication.
  
  
  RESULTS
  Resection was performed for advanced cutaneous malignant tumor in 10 patients, primary salivary gland malignant tumor in 4 patients, and chronic infection and mastoid cutaneous fistula in 2 patients. All defects were complex, involving multiple subsites; 5 patients underwent facial nerve resection and 4 had previous radiation therapy. No complete flap loss occurred. One partial flap loss occurred. The average flap island size was 7 × 10 cm. No major complications occurred. Two minor reconstruction site complications and 3 donor site seromas occurred.
  
  
  CONCLUSIONS
  The SCAIF can be successfully and reliably used for complex defects following parotid and LSB surgery. There are 3 important technique modifications to help facilitate rotation and coverage of this region.
authors.affiliation: Division of Head and Neck Surgical Oncology and Reconstruction, Massachusetts Eye and Ear Infirmary, Boston2Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Kevin S
authors.initials: KS
authors.lastname: Emerick
authors.affiliation: Division of Head and Neck Surgical Oncology and Reconstruction, Massachusetts Eye and Ear Infirmary, Boston2Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Marc W
authors.initials: MW
authors.lastname: Herr
authors.affiliation: Division of Head and Neck Surgical Oncology and Reconstruction, Massachusetts Eye and Ear Infirmary, Boston2Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Derrick T
authors.initials: DT
authors.lastname: Lin
authors.affiliation: Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts3Division of Otology and Neurotology, Massachusetts Eye and Ear Infirmary, Boston.
authors.forename: Felipe
authors.initials: F
authors.lastname: Santos
authors.affiliation: Division of Head and Neck Surgical Oncology and Reconstruction, Massachusetts Eye and Ear Infirmary, Boston2Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Deschler
mesh_terms: D000196:Actinomycosis / Q000601:surgery; D002277:Carcinoma / Q000601:surgery; D017577:Cutaneous Fistula / Q000382:microbiology / Q000601:surgery; D054644:Ear Auricle / Q000601:surgery*; D004428:Ear Neoplasms / Q000601:surgery; D006085:Graft Survival; D006801:Humans; D008416:Mastoid / Q000601:surgery; D010306:Parotid Gland / Q000601:surgery*; D012189:Retrospective Studies; D012468:Salivary Gland Neoplasms / Q000601:surgery; D012878:Skin Neoplasms / Q000601:surgery; D019291:Skull Base / Q000601:surgery*; D013524:Surgical Flaps / Q000098:blood supply*