Oral Cancer Reconstruction Using the Supraclavicular Artery Island Flap: Comparison to Free Radial Forearm Flap.
OBJECTIVE
To evaluate whether the pedicled supraclavicular artery island flap (SCAIF) is a sufficient alternative to the fasciocutaneous radial forearm free flap (RFFF) for oral reconstruction in cancer surgery.


METHODS
The authors designed and implemented a retrospective cohort study composed of all consecutive patients who underwent head and neck reconstruction after cancer surgery at their tertiary university hospital from 2013 to 2016. Demographics and peri- and postoperative information were recorded and statistically analyzed.


RESULTS
Of 83 patients who underwent head and neck reconstruction after cancer, 50 were identified as having stage III or IV squamous cell carcinoma of the oral cavity and oropharynx and underwent surgery and reconstruction with the SCAIF (n = 25) or the RFFF (n = 25). Total surgery time (411.0 vs 576.4 minutes; P < .001), flap elevation time (39.00 vs 93.78 minutes; P < .001), need for intensive care observation (32 vs 96%; P < .05), and rate of tracheotomy (64 vs 88%; P < .05) were significantly lower in the SCAIF group. There was no statistical difference in the postoperative complication rate or postoperative functional swallowing ability between the 2 groups. Total perioperative costs were significantly lower in patients who underwent reconstruction with the SCAIF (2,621.15 vs 4,453.77€; P < .01).


CONCLUSIONS
The results of this study suggest that the SCAIF is a straightforward and reliable flap with shorter operative times and comparable outcomes compared with the RFFF.
Assistant Medical Director and Senior Physician, Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany. Electronic address: christian.welz@med.uni-goettingen.de.
Christian
C
Welz
Professor and Head, Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany.
Martin
M
Canis
Medical-Technical Assistant, Department of Otorhinolaryngology, Head and Neck Surgery, Ludwig Maximilians University, Munich, Germany.
Sabina
S
Schwenk-Zieger
Resident, Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany.
Jennifer L
JL
Spiegel
Resident, Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany.
Bernhard G
BG
Weiss
Resident, Department of Otorhinolaryngology, Head and Neck Surgery, Georg August University, Goettingen, Germany.
Yiannis
Y
Pilavakis
D000368:Aged; D001158:Arteries; D015331:Cohort Studies; D005260:Female; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply*