The subscapular approach in head and neck reconstruction with the pedicled latissimus dorsi myocutaneous flap.

We have devised a new approach for transferring the pedicled latissimus dorsi myocutaneous flap to the head and neck region, and have applied it successfully in several patients. Our approach is rapid and increases the arc of rotation in order to cover defects of the lower lateral and posterior aspects of the head and neck. The vascular pedicle is protected between the scapula and the rib cage. We have used this approach in 15 patients over the last 9 years with good results.