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. © Wiley Periodicals Inc. Head Neck, 35: E328–E332, 2013

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Citing Literature

Volume35, Issue11

November 2013

Pages E328-E332

Use of a combined latissimus dorsi scapular free flap revascularized with vein grafting to the internal mammary artery in a vessel-depleted and previously irradiated neck

Abstract

Background

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

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Use of a combined latissimus dorsi scapular free flap revascularized with vein grafting to the internal mammary artery in a vessel-depleted and previously irradiated neck

Abstract

Background

Methods

Results

Conclusions

REFERENCES

Citing Literature

References

Related

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