Janik Stefan, Pyka Julian, Faisal Muhammad, Grasl Stefan, Golusinski Pawel, Marijić Blažen, Seemann Rudolf, Erovic Boban M
Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Vienna, 1090 Vienna, Austria.
Department of Oral and Maxillofacial Surgery, Medical University of Vienna, 1090 Vienna, Austria.
J Clin Med. 2022 Apr 25;11(9):2397. doi: 10.3390/jcm11092397.
To evaluate donor site morbidity of the serratus anterior free flap (SAFF) in head and neck reconstruction. The Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire (0 no disability to 100 most severe disability) was applied to 20 patients (M: 16; F: 4) who underwent ablative surgery and reconstruction of the head and neck using a SAFF. Applications, as well as the donor site, recipient site and flap-related complications, were evaluated. SAFF was mainly used for tongue ( = 11; 55.0%) and pharyngeal reconstruction after a laryngopharyngectomy ( = 4; 20.0%). The majority of patients presented with stage IV disease ( = 12; 60%) and had undergone previous radiotherapy ( = 14; 70%). Our free flap survival rate was 88.9% and the pectoralis major muscle flap (PMMF) was used in 5 patients as a salvage option to reconstruct pharyngeal defects. The mean/median DASH score was 21.6/19.9 (healthy norm 10.1), indicating only mild to moderate disability. However, free flap failure and the additional harvest of PMMF multiplies donor site morbidity since it was associated with a 3- and 2.6-times higher DASH score (46.0 vs. 15.5; = 0.039 and 39.9 vs. 15.47; = 0.081). The SAFF represents a versatile flap for head and neck reconstruction with low donor site morbidity.
评估前锯肌游离皮瓣（SAFF）在头颈部重建中的供区并发症。对20例（男性16例；女性4例）接受头颈部切除手术并使用SAFF进行重建的患者应用上肢、肩部和手部功能障碍（DASH）问卷（0表示无功能障碍，100表示最严重功能障碍）。评估应用情况以及供区、受区和皮瓣相关并发症。SAFF主要用于舌部重建（n = 11；55.0%）和喉咽切除术后的咽部重建（n = 4；20.0%）。大多数患者为IV期疾病（n = 12；60%），且曾接受过放疗（n = 14；70%）。我们的游离皮瓣存活率为88.9%，5例患者使用胸大肌肌皮瓣（PMMF）作为挽救措施来重建咽部缺损。DASH评分的平均值/中位数为21.6/19.9（健康标准为10.1），表明仅存在轻度至中度功能障碍。然而，游离皮瓣失败以及额外切取PMMF会增加供区并发症，因为这与DASH评分高出3倍和2.6倍相关（46.0对15.5；P = 0.039和39.9对15.47；P = 0.081）。SAFF是一种用于头颈部重建的多功能皮瓣，供区并发症发生率低。
