title: Palato-maxillary reconstruction by the angular branch-based tip of scapula free flap.
abstract: The angular branch (AB)-based tip of scapula free flap is a valuable reconstructive option in palato-maxillary defects needing significant structural support. We herein retrospectively evaluate our surgical series with special focus on functional outcomes and postoperative morbidity. Ninety-seven consecutive palatomaxillary oncologic resections were performed at our institution between August 2008 and November 2015. The analysis focused on those reconstructed by an AB-based tip of scapula free flap (N = 18; 19 %). A prospective assessment of donor site morbidity was performed by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire in 12 (67 %) patients. Among patients reconstructed by an AB-based tip of scapula free flap, 13 (72 %) had a Class II and 5 (28 %) a Class III defect according to Okay classification. Flap success rate was 94 %, with one failure requiring an anterolateral thigh flap. Eight (44 %) patients experienced recipient site complications, while donor site problems occurred in two only (11 %). Eleven (61 %) subjects were able to maintain a normal and 7 (39 %) a soft-to-firm diet. The mean DASH score was 10.5. Our results confirm that the AB-based tip of scapula free flap is a reliable choice in palatomaxillary reconstruction, with both satisfactory functional outcomes and negligible donor site morbidity.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy. ceceplaza@libero.it.
authors.forename: Cesare
authors.initials: C
authors.lastname: Piazza
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Paderno
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Del Bon
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Taglietti
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Grammatica
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Nausica
authors.initials: N
authors.lastname: Montalto
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, University of Brescia, Piazza Spedali Civili 1, 25123, Brescia, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Nicolai
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps; D006801:Humans; D007573:Jaw Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D056948:Orthognathic Surgical Procedures; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012540:Scapula
keywords: Free flaps; Functional results; Oncologic results; Palato-maxillary reconstruction; Tip of scapula