Shoulder morbidity in patients after reconstruction in the head and neck with a supraclavicular artery island flap (SCAIF)

Introduction:

The pedicled supraclavicular artery island flap (SCAIF) for reconstruction of the head and neck, has been shown to be a pliabe alternative to established pedicled flaps, such as the pectoralis major myocutaneous flap. Since there is limited published data regarding shoulder morbidity after SCAIF procedure, we aimed to investigate it the two established questionnaires for the upper extremity (Constant-Score and the DASH-Score).

Methods:

The authors designed and implemented a retrospective cohort study of patients who received a defect reconstruction by SCAIF. Analyzed parameters were demographics, comorbidities, donor site morbidity and shoulder morbidity in terms of range of motion (ROM), pain, strength and daily activities evaluated and compared between the donor site and contralateral arm.

Results:

Of 61 consecutive performed head and neck reconstructions with SCAIF, 20 met inclusion criteria (curative intended treatment, HNSCC, follow up time more than 4 months). Mean follow up was 17.3 months (± 10.4 months) ranging from 4 to 35 months. Donor site complication rate was low with 5% major (surgical revision) and 30% minor complications (conservative management). Overall Constant-Score (p = 0.33), pain (p = 0.15), overall ROM (p = 0.86) and strength of the extremity (p = 0.64) of the shoulder receiving a SCAIF showed no significant differences to the contralateral extremity. Mean of DASH-Score was 32.5 (± 28.6).

Conclusions:

The results of the present study suggest very low shoulder morbidity in patients after SCAIF procedure with no significant functional impairment of the donor shoulder compared to the contralateral side.

Publikationsverlauf

Publikationsdatum:
18. April 2018 (online)