Head and neck reconstruction with free flaps based on the thoracodorsal system. (December 2017)

• Record Type: Journal Article
• Authors: O'Connell, John Edward; Bajwa, Mandeep S; Schache, Andrew G.; Shaw, Richard J.
• Is Part Of: Oral oncology. Volume 75(2017)
• Page Start: 46
• Page End: 53
• Publication Date: 2017-12
• Subjects: Thoracodorsal -- Free flap -- Head and neck cancer -- Reconstruction; Mouth -- Cancer -- Periodicals; Mouth -- Tumors -- Periodicals; Mouth Diseases -- Periodicals; Mouth Neoplasms -- Periodicals; Bouche -- Cancer -- Périodiques; Bouche -- Tumeurs -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9943105
• DOI: 10.1016/j.oraloncology.2017.10.019
• Languages: English
• ISSNs: 1368-8375

Abstract

Highlights: Thoracodorsal system provides a range of soft tissue, osseous, and chimeric flaps. Latissimus Dorsi, Thoracodorsal Artery Perforator, Tip of Scapula available flaps. Useful in vessel depleted necks, multi-surface defects, elderly patients. Use has been well described in mandibular, maxillary, mid-face, and scalp defects. Technically challenging, but low morbidity relative to other free flap options. Abstract: The advent or micro-vascular free tissue transfer has facilitated the reconstruction of increasingly complex head and neck defects. There are multiple donor sites available, each with its' own advantages and disadvantages. However, the subscapular system, including the thoracodorsal system, provides the widest array of soft tissue and osseous flaps, as well as chimeric options. Its advantages include a long pedicle, independently mobile tissue components, relative sparing from atherosclerosis, and minimal donor site morbidity. The soft tissue flaps available from the thoracodorsal system include the Latissimus Dorsi, and Thoracodorsal Artery Perforator flaps, while the Tip of Scapula provides the osseous component. This review paper outlines the anatomical basis for these flaps, as well as describing their utility in head and neck reconstruction.