Usefulness of supraclavicular flap in reconstruction following resection of oral cancer

Objective: To evaluate the usefulness of supraclavicular artery ?ap in reconstruction of defects following resection of buccal mucosa cancer.Methods: Twenty-?ve patients who presented to R.L Jalappa Hospital and Research centre and diagnosed as squamous cell carcinoma of buccal mucosa staged Tand above were included in our study. All patients underwent wide excision of tumour and neck dissection. Six patients underwent hemi-mandibulectomy while 4 patients underwent marginal mandibulectomy depending on extent of the tumour along with neck dissection. The defect following surgery was reconstructed using the supraclavicular artery ?ap and were followed up for minimum 6 months during which they were assessed for the functional and aesthetic outcome using a scoring system. The details of the scoring system comprised of 7 attributes. Each attribute was given a score of 10 if the patients experienced that attribute, while a score of 0 was given if the patient did not experience that particular attribute.Results: Seven(28%) patients had complete necrosis of the ?ap. One patient had a local recurrence 2 months following surgery and was lost to follow up. The remaining 17 patients were followed up for a minimum of 6 months and a scoring system was adopted to evaluate the functional and aesthetic outcome of the supraclavicular ?ap. We observed that 14 patients had an excellent outcome score(58%), 3 patients had a good outcome score(13%), while 7 patients(28%) had ?ap necrosis.Conclusions: We ?nd the supraclavicular ?ap to be safe, technically simple, sensate, thin,pliable and reliable regional fasciocutaneous ?ap in reconstructing intra oral defects. Preserving the external jugular vein and sacri?cing supraclavicular nerves give good outcome.