Downloads
Abstract
Background: The supraclavicular artery island flap is a pedicled flap that offers a versatile reconstructive option for head and neck defects. Recent anatomical studies have improved our understanding of the vascular supply of the supraclavicular artery island flap. At our hospital, the supraclavicular artery island flap (SCAIF) has become a reliable option for fasciocutaneous coverage of complex head and neck defects. This study aims to describe the modified type of the supraclavicular artery flap in head and neck oncologic defects and reconstructive results.
Methods: A case series study of head and neck cancer who were treated by radical surgery or salvage surgery with reconstruction between January 2020 and March 2021 in HCMC Oncology Hospital; a prospective study. We assessed reconstructive techniques and outcomes.
Results: Seventeen cases underwent reconstructive surgery by supraclavicular artery island flap of which 15 were males and 2 females. The mean age was 49.6 (39-69 years old). Cases included carcinoma of the hypopharynx & larynx (13 cases), pharyngeal posterior wall (1 case) and squamous cell skin cancer (3 cases), staged III, IVA according to 8th AJCC Classification - 2017 or recurrence after initial therapy. Defects of the hypopharynx (4 cases), pharyngeal esophagus (5 cases), pharyngeal tongue base (2 cases), cervical esophagus (3) and cervico - facial skin were immediately reconstructed, the mean skin defect size was 10 cm × 17 cm; the smallest flap was 6 x 10 cm and the largest size was 11 x 26 cm. Our results with complete flap survival in 16/17 cases, a partial flap survival in one patient which required additional another flap. Three patients developed a pharyngeocutaneous fistula, 2 of which were wound infection and prolonged wound care (who had a history of previous radiation) and 1 case of partial flap loss mentioned above. All donor sites were closed primarily. There was no serious donor - site morbidity. Most patients fully recover their ability to swallow within two weeks after surgery and there was a restoration of sensation on the flap; the cosmetic result was excellent for 3 cases of skin cancer
Conclusions: The modified type of supraclavicular artery island flap is a thin versatile, safe, reliable, sensate, pliable fasciocutaneous pedicled flap that has low morbidity, with the good cosmetic and the functional outcome at both of recipient and donor - site, suitable for reconstructing of soft tissue in head and neck region
References
Gabrysz- Forget F, Tabet P, Ayad T. Free versus pedicled flaps for reconstruction of head and neck cancer defects: a systematic review. J of Otolaryngol - Head & Neck Surg. 2019. 48(1):13.
Nguyễn Việt Dũng, Phạm Như Hiệp, Nguyễn Hồng Lợi, Nguyễn Đình Tùng, Trần Xuân Phú, Lê Kim Hồng. Ứng dụng các vạt da - cơ - xương trong điều trị triệt căn và tái tạo cơ quan đối với ung thư đầu cổ tại Bệnh viện Trung ương Huế. Tạp chí Ung thư học Việt Nam. 2017. 1:15-27
Nguyễn Việt Dũng, Lê Văn Cường, Phạm Duy Hoàng, Nguyễn Đăng Khoa, Nguyễn Hoàng Thiên Bảo, Nguyễn Trần Minh Khánh, Đặng Thanh Hào, Trương Công Tuấn Anh. Phẫu thuật tái tạo trong ung thư da vùng đầu cổ lan rộng: kinh nghiệm và kỹ thuật hiện nay. Tạp chí ung thư học Việt Nam. 2021. 1: 41-51
Lamberty BG. The supraclavicular axial patterned flap. Britain Journal Plastic Surgery. 1979. 32(3):207-12.
Baudet & Martin. The supraclavicular neurovascular free flap. Anatomy and clinical application. Textbook of microsurgery 1983.
Baudet J, Martin D, Ferreira R, Buffet M, Rivet D, Kleiman L, et al. The supraclavicular neurovascular free flap. Anatomy and clinical applications. in: 3rd ed. Textbook of microsurgery. Masson, Paris1988: 169-175
Trần Thiết Sơn, Dương Mạnh Chiến. Tính linh hoạt của vạt da cân thượng đòn trong tạo hình khuyết phần mềm vùng cổ. Tạp chí Nghiên cứu Y học. 2013. 86(1): 43-50
Razdan SN, Albornoz CR, Ro T et al. Safety of the Supraclavicular Artery Island Flap (SAIF) in the setting of neck dissection and radiation therapy.J Reconstr Microsurg. 2015. 31(5):378–383.
Wang Z, Sano K, Inokuchi T, Lan X, Sekine J, Ikeda H. The free deltoid flap: Microscopic anatomy studies and clinical application to oral cavity reconstruction, Plast. Reconstr. Surg. 2003. 112(2): 404-11
Ki SH, Choi JH, Sim SH. Reconstructive Trends in PostAblation Patients with Esophagus and Hypopharynx Defect. Arch Craniofac Surg. 2015.16(3): 105-113
Pallua N, Machens HG, Rennekampff O, Becker M, Berger A. The fasciocutaneous supraclavicular artery island flap for releasing postburn mentosternal contractures. Plast Reconstr Surg. 1997. 99:1878-84
ES, Liu PH, Friedlander PL. Supraclavicular artery island flap for head and neck oncologic reconstruction: indications, complications, and
outcomes. Plast Reconstr Surg. 2009.124:115-23
Granzow JW, Suliman A, Roostaeian J, Perry A, Boyd JB. Supraclavicular artery island flap (SCAIF) vs free fasciocutaneous flaps for head and
neck reconstruction. Otolaryngol Head Neck Surg. 2013;148(6):941-8
Kokot N, Mazhar K, Reder LS, Peng GL, Sinha UK. The supraclavicular artery island flap in head and neck reconstruction: applications and
limitations. JAMA Otolaryngol Head Neck Surg. 2013.139:1247-55
Vermorken JB, Specenier P. Optimal treatment for recurrent/metastatic head and neck cancer. Ann Oncol. 2010. 21(7): 252-61.
| Published | 12-01-2025 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | No. 77 (2022) | |
| Section | Original article | |
| DOI | 10.38103/jcmhch.77.10 | |
| Keywords | Vạt thượng đòn, khuyết hổng vùng đầu cổ, ung thư vùng đầu cổ giai đoạn tiến triển, phẫu thuật tận gốc, phẫu thuật cứu vớt : Supraclavicular artery island flap, head and neck defect, advancedstage head and neck cancer, radical surgery, salvage surgery |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2022 Journal of Clinical Medicine Hue Central Hospital