Serratus Anterior Free Flap in Oral Reconstruction
Purpose
Perforating oral and maxillofacial defects frequently cause severe functional disorders. Microvascular free flaps like the radial forearm flap and the latissimus dorsi flap have been described to cover those defects; however, harvest of the radial forearm flap causes remarkable donor-site morbidity, while the latissimus dorsi flap often turns out to be too bulky. Therefore we introduce the serratus anterior muscle as a versatile and reliable microvascular flap to cover defects of both the floor of the mouth and the maxilla.
Patients and Methods
Between 2003 and 2007, 10 oral defects were reconstructed using the serratus anterior flap. In 5 of the cases, the defects were located at the hard palate and maxilla, while in the other cases they were located in the floor of the mouth.
Results
All of the patients were able to feed orally within the first week postoperatively. Donor-site morbidity was observed to be negligible not least because of the achievement of primary tension-free wound closure. Successful reconstruction could be observed in 8 of 10 patients.
Conclusion
Although the serratus anterior muscle flap lacks an epithelial layer, this flap is not restricted to a subcutaneous placement. Due to rapid epithelialization, the serratus anterior muscle is even suitable for perforating intraoral defects.
⁎Consultant, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
†Consultant, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
‡Consultant, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
§Consultant, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
∥Consultant, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
¶Consultant, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
#Department Head, Department of Oral and Maxillofacial Surgery, Hannover Medical School, Hannover, Germany
Address correspondence and reprint requests to Dr Tavassol: Department of Oral and Maxillofacial Surgery, Hannover Medical School, Carl-Neuberg-straße 1, 30625 Hanover, Germany
ABSTRACT