The Supraclavicular Artery Flap for Lateral Skull and Scalp Defects: Effective and Efficient Alternative to Free Tissue Transfer

 

 Permissions and Reprints

Abstract

Objectives Describe the use of the supraclavicular artery flap for reconstruction of lateral skull and scalp defects. Discuss advantages and potential limitations of the supraclavicular artery flap.

Design Case series.

Setting Tertiary care academic medical center.

Participants Patients undergoing lateral scalp and skull base resections.

Main Outcome Measures Effectiveness in reconstructing lateral skull base defects and complications.

Results All three patients reconstructed with the supraclavicular artery flap had excellent reconstructive outcomes. There were no flap losses, either complete or partial. There were no major complications, but one patient had a significant donor site dehiscence requiring local wound care. Referred sensation to the shoulder was alleviated by division of the sensory innervations into the flap.

Conclusions The supraclavicular artery flap is an excellent option for lateral skull and scalp defects, and donor site morbidity is limited. It should be considered as an alternative to free tissue transfer.

• References

• 1 Gal TJ, Kerschner JE, Futran ND , et al. Reconstruction after temporal bone resection. Laryngoscope 1998; 108 (4, Pt 1): 476-481
  CrossrefPubMedGoogle Scholar
• 2 Netterville JL, Wood DE. The lower trapezius flap. Vascular anatomy and surgical technique. Arch Otolaryngol Head Neck Surg 1991; 117 (1) 73-76
  CrossrefPubMedGoogle Scholar
• 3 Resto VA, McKenna MJ, Deschler DG. Pectoralis major flap in composite lateral skull base defect reconstruction. Arch Otolaryngol Head Neck Surg 2007; 133 (5) 490-494
  CrossrefPubMedGoogle Scholar
• 4 O'Connell DA, Teng MS, Mendez E, Futran ND. Microvascular free tissue transfer in the reconstruction of scalp and lateral temporal bone defects. J Craniofac Surg 2011; 22 (3) 801-804
  CrossrefPubMedGoogle Scholar
• 5 Lamberty BG. The supra-clavicular axial patterned flap. Br J Plast Surg 1979; 32 (3) 207-212
  CrossrefPubMedGoogle Scholar
• 6 Pallua N, Magnus Noah E. The tunneled supraclavicular island flap: an optimized technique for head and neck reconstruction. Plast Reconstr Surg 2000; 105 (3) 842-851 ; discussion 852–854
  CrossrefPubMedGoogle Scholar
• 7 Chiu ES, Liu PH, Friedlander PL. Supraclavicular artery island flap for head and neck oncologic reconstruction: indications, complications, and outcomes. Plast Reconstr Surg 2009; 124 (1) 115-123
  CrossrefPubMedGoogle Scholar
• 8 Pallua N, Wolter TP. Defect classification and reconstruction algorithm for patients with tracheostomy using the tunneled supraclavicular artery island flap. Langenbecks Arch Surg 2010; 395 (8) 1115-1119
  CrossrefPubMedGoogle Scholar
• 9 Pointer Jr DT, Friedlander PL, Amedee RG, Liu PH, Chiu ES. Infratemporal fossa reconstruction following total auriculectomy: an alternative flap option. J Plast Reconstr Aesthet Surg 2010; 63 (8) e615-e618
  CrossrefPubMedGoogle Scholar
• 10 Nthumba PM. The supraclavicular artery flap: a versatile flap for neck and orofacial reconstruction. J Oral Maxillofac Surg 2012; 70 (8) 1997-2004
  CrossrefPubMedGoogle Scholar
• 11 Vinh VQ, Van Anh T, Ogawa R, Hyakusoku H. Anatomical and clinical studies of the supraclavicular flap: analysis of 103 flaps used to reconstruct neck scar contractures. Plast Reconstr Surg 2009; 123 (5) 1471-1480
  CrossrefPubMedGoogle Scholar
• 12 Sands TT, Martin JB, Simms E, Henderson MM, Friedlander PL, Chiu ES. Supraclavicular artery island flap innervation: anatomical studies and clinical implications. J Plast Reconstr Aesthet Surg 2012; 65 (1) 68-71
  CrossrefPubMedGoogle Scholar
• 13 Eldaly A, Magdy EA, Nour YA, Gaafar AH. Temporalis myofascial flap for primary cranial base reconstruction after tumor resection. Skull Base 2008; 18 (4) 253-263
  Article in Thieme ConnectPubMedGoogle Scholar
• 14 Hanasono MM, Sacks JM, Goel N, Ayad M, Skoracki RJ. The anterolateral thigh free flap for skull base reconstruction. Otolaryngol Head Neck Surg 2009; 140 (6) 855-860
  CrossrefPubMedGoogle Scholar
• 15 Adams AS, Wright MJ, Johnston S , et al. The use of multislice CT angiography preoperative study for supraclavicular artery island flap harvesting. Ann Plast Surg 2012; 69 (3) 312-315
  CrossrefPubMedGoogle Scholar
• 16 Sands TT, Martin JB, Simms E, Henderson MM, Friedlander PL, Chiu ES. Supraclavicular artery island flap innervation: anatomical studies and clinical implications. J Plast Reconstr Aesthet Surg 2012; 65 (1) 68-71
  CrossrefPubMedGoogle Scholar