Lateral Scapular Border Free Flap for Head and Neck Reconstruction

Amanian, Ameen; M Bur, Andrés

Lateral Scapular Border Free Flap for Head and Neck Reconstruction

Open Education Resource

2025-10-31

Abstract

The lateral scapular border free flap (LSBFF) is a versatile component of the subscapular system, widely utilized in head and neck reconstruction. Harvested as an osseous or osteocutaneous free flap, the LSBFF is based on the circumflex scapular artery (CSA) and may incorporate skin, muscle, and up to 13 cm of bone from the lateral scapular border. The osseous segment, supplied by periosteal perforators from the CSA, allows for multiple osteotomies for reconstructing multi-segment mandibular or midface defects. The flap’s versatility enables chimeric reconstructions, combining scapular or parascapular skin paddles (based on the transverse or descending branches of the CSA, respectively) or including additional tissues such as the latissimus dorsi or serratus anterior musculature supplied by the thoracodorsal artery. The CSA and accompanying circumflex scapular vein (CSV) can be traced to the subscapular artery and vein for increased pedicle length and vessel caliber, facilitating microvascular anastomosis.

Keywords

Lateral Scapular Border Free Flap

Head and Neck Reconstruction

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