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Reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps

BACKGROUND: Oral cavity reconstruction is very challenging anatomical subsite to reconstruct. Large defects often require free tissue reconstruction to provide the best chance of form and function. Additionally, free tissue reconstruction aids to prevent fistula formation. We aimed to determine outc...

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Autores principales: Barton, Blair M., Pappa, Andrew K., Blumberg, Jeffrey, Patel, Samip
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley & Sons, Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392378/
https://www.ncbi.nlm.nih.gov/pubmed/36000052
http://dx.doi.org/10.1002/lio2.848
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author Barton, Blair M.
Pappa, Andrew K.
Blumberg, Jeffrey
Patel, Samip
author_facet Barton, Blair M.
Pappa, Andrew K.
Blumberg, Jeffrey
Patel, Samip
author_sort Barton, Blair M.
collection PubMed
description BACKGROUND: Oral cavity reconstruction is very challenging anatomical subsite to reconstruct. Large defects often require free tissue reconstruction to provide the best chance of form and function. Additionally, free tissue reconstruction aids to prevent fistula formation. We aimed to determine outcomes of oral cavity defect reconstruction using scapular tip free flaps with a myogenous intraoral component. METHODS: All patients with a mandibular or maxillary bony defect that included a disruption of the intraoral mucosa component between 07/1/14 and 07/31/17. Patients were reconstructed with a scapular tip free flap, which included a muscular component that was used to recreate the oral mucosa. The primary study outcomes were flap success rates, development of orocutaneous or oronasal fistula, rate of resuming oral diet as well as the occurrence of medical and surgical complications in the first month following surgery. The tested hypothesis was formulated before data collection began. RESULTS: Twenty‐five patients were identified by the study criteria. There was one (4%) flap that failed, while orocutaneous fistula occurred in two patients (8%). Prior history of osteoradionecrosis was a statistically significant predictor of overall complication (p < .05). CONCLUSIONS: Intraoral myogenous reconstruction allows for re‐mucosalization of the oral cavity defect and is associated with high viability and low‐complication rates. In patients with amenable oral mucosal defects, a myogenous scapular tip free flap is a suitable reconstructive option.
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spelling pubmed-93923782022-08-22 Reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps Barton, Blair M. Pappa, Andrew K. Blumberg, Jeffrey Patel, Samip Laryngoscope Investig Otolaryngol Facial Plastics and Reconstructive Surgery BACKGROUND: Oral cavity reconstruction is very challenging anatomical subsite to reconstruct. Large defects often require free tissue reconstruction to provide the best chance of form and function. Additionally, free tissue reconstruction aids to prevent fistula formation. We aimed to determine outcomes of oral cavity defect reconstruction using scapular tip free flaps with a myogenous intraoral component. METHODS: All patients with a mandibular or maxillary bony defect that included a disruption of the intraoral mucosa component between 07/1/14 and 07/31/17. Patients were reconstructed with a scapular tip free flap, which included a muscular component that was used to recreate the oral mucosa. The primary study outcomes were flap success rates, development of orocutaneous or oronasal fistula, rate of resuming oral diet as well as the occurrence of medical and surgical complications in the first month following surgery. The tested hypothesis was formulated before data collection began. RESULTS: Twenty‐five patients were identified by the study criteria. There was one (4%) flap that failed, while orocutaneous fistula occurred in two patients (8%). Prior history of osteoradionecrosis was a statistically significant predictor of overall complication (p < .05). CONCLUSIONS: Intraoral myogenous reconstruction allows for re‐mucosalization of the oral cavity defect and is associated with high viability and low‐complication rates. In patients with amenable oral mucosal defects, a myogenous scapular tip free flap is a suitable reconstructive option. John Wiley & Sons, Inc. 2022-07-08 /pmc/articles/PMC9392378/ /pubmed/36000052 http://dx.doi.org/10.1002/lio2.848 Text en © 2022 The Authors. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals LLC on behalf of The Triological Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Facial Plastics and Reconstructive Surgery
Barton, Blair M.
Pappa, Andrew K.
Blumberg, Jeffrey
Patel, Samip
Reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps
title Reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps
title_full Reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps
title_fullStr Reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps
title_full_unstemmed Reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps
title_short Reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps
title_sort reconstruction of oral cavity defects using myogenous‐only scapular tip free‐flaps
topic Facial Plastics and Reconstructive Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9392378/
https://www.ncbi.nlm.nih.gov/pubmed/36000052
http://dx.doi.org/10.1002/lio2.848
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