Abstract
Objectives
This study aimed to compare the clinical outcomes of fibular (FFF group) and scapular
(SFF group) osseous free flaps for reconstructing head and neck defects for primary
surgery and salvage options.
Methods
We analyzed 156 cases of osseous free flaps in 138 patients from a retrospective review
of a single institutional database between January 1996 and January 2020 (FFF, 114
cases in 99 patients; SFF, 42 cases in 39 patients). Clinical profiles such as age,
sex, primary tumor site, and defect type were investigated in the two groups. In addition,
the incidences and types of perioperative complications, flap compromise, and salvage
management were compared between the two groups.
Results
FFF was used mostly for oromandibular defects, whereas SFF was preferred for maxillary
defect reconstruction. The length of hospital stay was longer in the FFF group than
in the SFF group. The flap compromise rate was not significantly different between
the two groups; however, donor-site complications were not observed in the SFF group
as compared to 7.9% in the FFF group. A regional or free (musculo) cutaneous flap
was used as a salvage procedure in partial flap compromise. Contralateral SFF was
available to replace a completely compromised SFF, whereas it was not feasible in
a completely compromised FFF. Cox proportional hazards analysis showed no significant
prognostic factors for flap-related complications.
Conclusion
The two osseous free flaps showed differences in defect type, flap donor complications,
and options for compromised flap salvage. These findings must be considered carefully
in the preoperative planning stage to guarantee early recovery and timely administration
of postoperative adjuvant treatment if necessary.
Keywords
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Article info
Publication history
Published online: January 27, 2023
Accepted:
January 3,
2023
Received:
July 15,
2022
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 Japanese Society of Otorhinolaryngology-Head and Neck Surgery, Inc. Published by Elsevier B.V. All rights reserved.
