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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.
MedLine Citation:
PMID:  23152141     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
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. © Wiley Periodicals Inc. Head Neck, 2012.
Authors:
William E Karle; Sumeet M Anand; Jason B Clain; Sophie Scherl; Daniel Buchbinder; Mark L Smith; Mark L Urken
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-14
Journal Detail:
Title:  Head & neck     Volume:  -     ISSN:  1097-0347     ISO Abbreviation:  Head Neck     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-15     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8902541     Medline TA:  Head Neck     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Wiley Periodicals, Inc.
Affiliation:
Albert Einstein College of Medicine, New York, New York; Thyroid Head and Neck Cancer Foundation, New York, New York. karle@med.einstein.yu.edu.
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