Is it necessary to use the angular artery to feed the scapular tip when preparing a latissimus dorsi osteomyocutaneous flap?: Case report

This report demonstrates the possibility of elevation of the scapular tip w ith the latissimus dorsi muscle based on the thoracodorsal artery only, whe n an additional and substantial amount of bone is required for complex reco nstruction. The patient was a 37-year-old man who developed an epidermoid c arcinoma arising from the left maxillary sinus. After wide excision and rad ical resection of the tumor and the invaded structures, an osteomycutaneous latissimus dorsi flap was prepared, With the muscle, the 12th rib was incl uded in the flap to reconstruct the orbital floor and zygomatic arch, and t he scapular tip was also elevated to reconstruct the hard palate, The skin island over the muscle was designed according to reconstructive requirement s, including the buccal lining, nasal lateral wall lining, and coverage of the scapular tip at its new location to reconstruct the hard palate. Ail of these structures were successfully reconstructed with a single pedicle bra nch arising from the thoracodorsal artery. Postoperative early and late bon e scans showed living bone at the zygomatic arch and hard palate.