INTRODUCTION
Scapular/Parascapular free tissue transfer (SFTT) is a versatile tool in
head and neck reconstructive surgery. Free flaps based off the
subscapular system allow the surgeon to harvest a combination of soft
tissue, bone, and muscle with limited donor site morbidity. Blood supply
to the skin paddle is composed of skin perforators from the vascular
pedicle allowing safe manipulation and contouring during flap inset.
The majority studies pertaining to SFTT report outcomes of
reconstruction of oromandibular and midface
defects.1,2 Limited data has been published on
pharyngoesophageal(PE) reconstruction with many studies focusing on
radial forearm or anterolateral thigh free flap
reconstruction.3,4
Complications from failed PE reconstruction can often be life
threatening and delay adjuvant cancer treatment. Patients who develop
pharyngocutaneous fistula (PCF) experience increased duration of
hospital stay, are prone to infection, and risk carotid blowout.
Moreover, many who develop fistula, have stricture and are gastrostomy
tube (G-tube) dependent. SFTT has the potential to limit these
complications due to abundant soft tissue and skin capable of
reconstructing circumferential defects. Fasciocutaneous (FC) SFTT can
also be designed to fill cervical skin defects and protect great
vessels.
The objective of this study is to describe our institution’s experience
with SFTT for the reconstruction of PE deficits. This review will focus
on surgical outcomes of PE defect closure, donor site morbidity, and
speech and swallowing function.