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.