Department of Maxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Alexandria, Egypt.
Department of Diagnostic and Interventional Radiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Oral Maxillofac Surg. 2024 Jun;28(2):893-908. doi: 10.1007/s10006-024-01225-2. Epub 2024 Feb 14.
Several surgical modalities are available for maxillofacial reconstruction as locoregional or microvascular free flaps.
(a) Evaluate the reliability of the supraclavicular flap in cervico-orofacial region; (b) investigate the role of computed tomography angiography (CTA) in predicting the post-operative viability of the flap; (c) assess the speech, feeding, and esthetics after reconstruction using this flap.
Eleven patients included in this study underwent either conventional or delayed harvesting of the supraclavicular flap (SCF). All the patients had diagnostic computed tomography angiography (CTA) of the supraclavicular flap before the surgery.
The mean harvesting time of the flap was 45.45 ± 4.16 min. The average length of the flap was 22.64 ± 1.12 cm, whereas the mean width of the flap was 6.14 ± 1.14 cm. The flap survived in 9 patients, while two patients had complete flap loss. After the surgery, three patients complained of speech difficulties. Two patients had swallowing problems. After the surgery, three patients complained of speech difficulties. Two patients had swallowing problems. Only two patients complained of weakness in the donor site. None of the patients reported that the weakness or pain at the donor site affected their daily activities or quality of life.
The pedicled SCF represents a safe and feasible option that can be used to reconstruct a wide array of maxillofacial oncologic defects. However, a study with a larger sample size is recommended to achieve more reliable clinical results for the modified delayed technique modification in terms of their effect on the survival of the supraclavicular flap.
目的：（a）评估锁骨上皮瓣在颈面部区域的可靠性；（b）研究计算机断层血管造影（CTA）在预测皮瓣术后存活能力方面的作用；（c）评估使用该皮瓣重建后的言语、进食和美观效果。
方法：11 例患者接受了锁骨上皮瓣的常规或延迟采集。所有患者均在手术前进行了锁骨上皮瓣的诊断性 CT 血管造影（CTA）。
结果：皮瓣的平均采集时间为 45.45±4.16 分钟。皮瓣的平均长度为 22.64±1.12 厘米，平均宽度为 6.14±1.14 厘米。9 例皮瓣存活，2 例患者完全皮瓣坏死。术后 3 例患者诉言语困难。2 例患者有吞咽问题。术后仅 2 例患者供区有乏力感。无患者报告供区的乏力或疼痛影响其日常活动或生活质量。
结论：带蒂锁骨上皮瓣是一种安全可行的选择，可用于重建广泛的颌面肿瘤缺损。然而，建议进行更大样本量的研究，以获得关于改良延迟技术对锁骨上皮瓣存活影响的更可靠的临床结果。
