Blumberg Jeffrey M, Walker Paul, Johnson Stephanie, Johnson Bradley, Yu Eugene, Lacasse Marie-Constance, Lam David K, Rittenberg Brian, Yao Christopher M K L, Chepeha Douglas, de Almeida John R, Goldstein David P, Gilbert Ralph
Department of Otolaryngology - Head and Neck Surgery, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Ontario, Canada.
Department of Medical Imaging, University Health Network, Princess Margaret Cancer Center, University of Toronto, Toronto, Ontario, Canada.
Head Neck. 2019 Jul;41(7):2353-2358. doi: 10.1002/hed.25702. Epub 2019 Mar 14.
The scapula tip free flap has been described for reconstruction of short mandible defects with extensive soft tissue needs. The versatility of this flap has not been extensively described.
Retrospective case series of patients who underwent mandibulectomy and reconstruction with the scapula tip free flap from 2005 to 2016. Outcomes include bony union, complications, dental rehabilitation, and donor site morbidity.
A total of 120 patients were identified. Average harvested bone was 7.7 cm, with 54% undergoing one osteotomy, and 76.7% harvested as a chimeric flap. Radiographically, average inset bone was 6.6 cm. Complete or partial bony union was observed at 74.4% of proximal and 82.6% of distal osteotomies. A 95% of reconstructions met criteria for dental implants. Mean disabilities of the arm, shoulder and hand score was 21.2.
The scapular tip is an excellent option for reconstruction of segmental mandible defects with the option of osteotomy, excellent bony union rates, low donor site morbidity, and potential for dental rehabilitation.
肩胛尖游离皮瓣已被用于需要大量软组织的下颌骨短节段缺损的重建。该皮瓣的多功能性尚未得到广泛描述。
对2005年至2016年接受下颌骨切除术并采用肩胛尖游离皮瓣重建的患者进行回顾性病例系列研究。结果包括骨愈合、并发症、牙齿修复和供区发病率。
共纳入120例患者。平均取骨长度为7.7 cm，54%的患者进行了一次截骨，76.7%的患者采用嵌合皮瓣取骨。影像学检查显示，平均植入骨长度为6.6 cm。近端截骨处74.4%和远端截骨处82.6%观察到完全或部分骨愈合。95%的重建符合牙种植标准。手臂、肩部和手部功能障碍平均评分为21.2。
肩胛尖是重建节段性下颌骨缺损的极佳选择，可选择截骨，骨愈合率高，供区发病率低，且有牙齿修复的潜力。
