AB198. SOH24AB_226. Supraclavicular flap in the reconstruction of oncologic defects in the head and neck

Background: Microvascular free flaps have been widely adopted as the gold standard for reconstruction of oncologic defects in the oral cavity. However, this approach necessitates lengthy surgery & prolonged hospital stay, often contraindicated in the comorbid oncology patient. The supraclavicular flap (SCF) is an alternative reconstructive approach, that poses distinct advantages to microvascular anastomosis. The SCF is a fasciocutaneous, pedicled flap based on the supraclavicular artery. It can be utilised in cutaneous and mucosal reconstructions, for traumatic and oncologic defects of the head and neck. We present a case series of four patients who underwent SCF reconstruction of the tongue, following tumour resection.

Methods: Four patients with varying primary tumour size (T1–T3) underwent surgical excision of oral squamous cell carcinoma of the lateral tongue. A skin paddle was then raised from the subfascial plane of the deltoid muscle, and tunnelled through the floor of mouth to close the surgical site.

Results: All four patients were successfully treated with a SCF. There were three female and one male patient, with a mean age of 68 years. One patient experienced partial flap dehiscence that did not require further surgical intervention. There was no incidence of complete flap necrosis. All patients exhibited satisfactory speech and swallow outcomes at one-month post-operation.

Conclusions: SCF should be considered as an alternative to free flap in the armamentarium of the oral & maxillofacial surgeon. It demonstrates comparable success rates to free flaps, and may decrease perioperative morbidity and overall cost of care.

Keywords: Microvascular free flap; oral cavity; oral squamous cell carcinoma; pedicled flap; supraclavicular flap (SCF)