Bilateral tunneled supraclavicular island flaps for simultaneous reconstruction of massive facial defect and intraoral lining.

Reconstructive procedures in the head and neck region use a wide range of flaps for defect closure. The methods range from local, mostly myocutaneous flaps and skin grafts to free microsurgical flaps. To ensure a satisfactory functional and aesthetic result, good texture and color of the flap are always essential. Moreover, the donor-site defect needs to be reduced, with no resulting functional or aesthetic impairment. The supraclavicular island flap has been used successfully for difficult facial reconstruction cases, providing acceptable results without using microsurgical techniques. As a complementary study to the publication by Heitland and Pallua (Plast Reconstr Surg 2005;115:1591), we report our preliminary clinical experience with bilateral tunneled supraclavicular island flaps for simultaneous reconstruction of massive facial defect and intraoral lining in massively progressed invasive squamous cell carcinoma of the lower lip with severe intraoral extension. This thin flap is easy and quick to harvest, has a reliable pedicle, and has minimal donor-site morbidity. It is now the authors' flap of choice for many common head and neck reconstructive problems.