Rekonstruktion mit dem supraklavikulären Insellappen: Eine Alternative in der onkologischen Therapie von Kopf-Hals-Karzinomen

Background: Reconstruction of defects after extirpation of head and neck cancer is a highly challenging and complex surgical undertaking. Commonly used techniques, e.g., the radial forearm flap, the anterior lateral thigh flap, or flaps harvested from the chest—deltopectoral or pectoralis major—share numerous disadvantages, such as donor-site morbidity, poor color matching for cutaneous reconstruction, and excessive tissue bulk. The use of a supraclavicular artery island flap is a long–forgotten but increasingly popular option for reconstruction in the head and neck area. Materials and methods: In the period 03/2013–02/2016, a total of 12 patients were treated with a supraclavicular island flap after surgical resection of carcinoma of the oral cavity, pharynx, parotid, or facial skin. Results: Using examples, reconstruction of the lateral tongue and tongue base following resection of a squamous cell carcinoma, and reconstruction of the parotideal region after total parotidectomy and neck dissection for a skin spinalioma that had infiltrated the parotid are reported. In both patients, the flap healed without problems and led to very good functional and cosmetic outcomes. Conclusion: The supraclavicular island flap is a reliable and versatile flap for reconstruction in the head and neck region. Minimal donor-site morbidity, excellent cosmetic properties, and the relative ease of preparation and use compared to other distant flaps render it an excellent reconstructive tool for ENT surgeons.