Oral Cancer Reconstruction using the Supraclavicular Artery Island Flap: Comparison to Free Radial Forearm Flap

Publication date: Available online 2 March 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Christian Welz, Martin Canis, Sabina Schwenk-Zieger, Jennifer L. Spiegel, Bernhard G. Weiß, Yiannis Pilavakis
PurposeTo evaluate if the pedicled supraclavicular artery island flap (SCAIF) is a sufficient alternative to the fasciocutaneous radial forearm flap (RFFF) for oral reconstruction in cancer surgery.Patients and MethodsThe investigators designed and implemented a retrospective cohort study composed of all consecutive patients that underwent head and neck reconstruction after cancer surgery at our tertiary university hospital between 2013 and 2016. Demographics, peri- and postoperative information were recorded and statistical analyzed.ResultsFrom a total of 83 patients who underwent head and neck reconstruction after cancer, 50 were identified with stage III/IV squamous cell carcinoma of the oral cavity and the oropharynx who underwent surgery and reconstruction with SCAIF (n=25) or with RFFF (n=25). The total surgery time (411.0 vs. 576.4 min; p<0.001), flap elevation time (39.00 vs. 93.78 min; p<0.001), need for an intensive care observation (32 vs. 96%; p<0.05) and the rate of tracheostomy (64 vs. 88%; p<0.05) were significantly lower in the SCAIF group. There was no statistical difference in the postoperative complication rate or the postoperative functional swallowing ability between the two groups. The total perioperative costs were significantly lower in patients receiving a reconstruction with SCAIF (2621.15 vs. 4453.77; p<0.01).ConclusionThe results of this study suggest that SCAIF is an easy and reliable flap with shorter operative times and comparable outcomes when compared to the RFFF.



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