Clinical Applications and Outcomes of the Supraclavicular Osteocutaneous Flap for Head and Neck Reconstruction

ObjectiveThis study evaluates the clinical applications of the supraclavicular osteocutaneous (SOC) flap in complex head and neck reconstruction and its impact on shoulder function following clavicle resection.Study DesignCase series with a planned chart review.SettingSingle-institution tertiary care center.MethodsWe reviewed patients with complex mandibular and maxillary defects who underwent SOC flap reconstruction from 2016 to 2020. We detailed flap harvesting techniques, patient characteristics, diagnoses, defect sites, bone dimensions, skin paddle size, vascular supply, and donor site management. Complications and outcomes were also documented.ResultsThe study included 7 patients with diverse clinical conditions and diagnoses. Reconstruction techniques varied, leading to different clavicle thicknesses and skin paddle sizes. Two cases had flap necrosis due to infection, and 1 experienced chronic shoulder discomfort following partial-thickness clavicle flap surgery. Full-thickness clavicle harvesting resulted in better outcomes and simplified the procedure. Notably, there were no significant long-term complications affecting shoulder function.ConclusionThe SOC flap is a promising option for complex head and neck reconstruction, adaptable to specific case requirements and providing reliable vascular supply. It offers favorable clinical outcomes both functionally and aesthetically. Full-thickness clavicle harvesting, with joint preservation, effectively maintains shoulder function.