Chimaeric subscapular system free flap for complex oro-facial defects

B. L'Heureux-Lebeau, A. Odobescu, P. G. Harris, L. Guertin, A. M. Danino

Research output: Contribution to journalArticlepeer-review

14 Scopus citations


Background Ablation of locally advanced head and neck cancers generally results in large composite oro-facial defects. Due to the often-large segment of mandible missing, as well as the need to provide skin coverage and oral lining, reconstructive options are limited. We present our experience in oncologic head and neck reconstruction using chimaeric subscapular system free flaps. Methods We performed a retrospective chart review of patients presenting important through-and-through oro-facial defects following ablation of T3, T4a or T4b tumours in two university centres between 2005 and 2011. All defects were reconstructed with a subscapular system free flap that was harvested in a dorsal decubitus position. Results Sixteen patients (15 M, 1 F; mean age = 60 years) underwent mandibular reconstruction with latissimus dorsi flaps with one or two skin paddles and one bony component based on the angular branch of the thoracodorsal artery. Fifteen patients received adjuvant radiotherapy. We experienced no flap loss. Donor-site complications were minimal, albeit a limitation of shoulder range of motion was found in four patients. Eight patients presented postoperative complications requiring re-intervention. Fourteen patients were able to recommence oral nutrition and their diction returned to normal in all but one. The mean follow-up period was 25 months. Aesthetic results were satisfactory upon atrophy of the latissimus dorsi muscle. Conclusions In cases of extensive oro-facial defects involving a large mandibular segment, reconstruction with subscapular system free-tissue transfer is a safe and reliable technique that offers satisfactory functional and aesthetic results.

Original languageEnglish (US)
Pages (from-to)900-905
Number of pages6
JournalJournal of Plastic, Reconstructive and Aesthetic Surgery
Issue number7
StatePublished - Jul 2013
Externally publishedYes


  • Chimaeric free flap
  • Head and neck
  • Mandible reconstruction
  • Oral cancer

ASJC Scopus subject areas

  • Surgery


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