Abstract
Background For patients who have extensive prior treatment, use of the internal mammary artery/vein (IMA/IMV) or cephalic vein has been shown to be a reliable option. Additionally, for those patients who require vascularized bone and extensive soft tissue reconstruction, the combined latissimus dorsi scapular free flap (mega-flap) is an excellent option. Methods We reviewed 3 cases in which extensive prior surgery and radiation precluded the use of traditional recipient vessels in the neck. Results Three patients with major jaw deformities were reconstructed using a mega-flap. In all cases, saphenous vein grafting succeeded in achieving arterial inflow from the IMA to the subscapular artery. Venous egress was achieved using a vein graft to the IMV in 1 patient and a transposed cephalic vein in the remaining 2 patients. Conclusions This approach of restoring large oral cavity defects for patients with extensive prior therapy and comorbid conditions has proven to be reliable and reproducible.
Original language | English |
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Pages (from-to) | E328-E332 |
Journal | Head and Neck |
Volume | 35 |
Issue number | 11 |
DOIs | |
State | Published - Nov 2013 |
Externally published | Yes |
Keywords
- internal mammary vessels
- latissimus dorsi scapular free flap
- microvascular reconstruction
- vein graft
- vessel-depleted neck