ABSTRACT
Many microsurgical free flaps have been described to tackle various problems in the head and neck. The authors present a system of indications which has proved to be suitable as judged by the functional and cosmetic results obtained. The harvesting of these flaps requires versatile training in surgical techniques for the different anatomical areas. This system of indications comprises the free fasciocutaneous forearm flap, jejunal loops, the fasciocutaneous parascapular flap, iliac crest flaps with vascularized bone and the parascapular cutaneous, latissimus dorsi osteomyocutaneous double flap.
Subject(s)
Head and Neck Neoplasms/surgery , Microsurgery/methods , Surgical Flaps/methods , Bone Transplantation/methods , Esophageal Neoplasms/surgery , Humans , Hypopharyngeal Neoplasms/surgery , Mandibular Neoplasms/surgery , Mouth Neoplasms/surgery , Oropharyngeal Neoplasms/surgery , Suture TechniquesABSTRACT
The authors present two microsurgical options of the reconstruction of the lower third of the face. They outline a systematisation of indications and techniques and emphasise versatility and flexibility of free flaps compared to pedicled flaps, and describe the advantages of the vascularisation and the techniques of the iliac crest osteocutaneous flap and the parascapular cutaneous-latissimus dorsi osteomyocutaneous flap which was developed by Nassif.
Subject(s)
Bone Transplantation , Mandible/surgery , Mandibular Neoplasms/surgery , Microsurgery/methods , Humans , Surgical Flaps , Wound HealingABSTRACT
We present the anatomic study and the clinical free transfer of a new donor site. This new flap is called the parascapular flap. It is under the dependence of a direct cutaneous artery that is a vertical terminal branch of the circumflex scapular artery, itself a branch of the subscapular artery. The flap is outlined along the free lateral border of the scapula, and it provides large surface coverage with easy primary closure of the donor site. The surface can even be extended by association of the flap with the latissimus dorsi muscle flap. With this flap, both skin and muscle areas are under the dependence of a single pedicle that is the subscapular artery.
