Microvascular Orofacial Reconstruction: Free Fibula Flap/ Scapula Flap

Reconstruction of extensive orofacial defects pertaining to oncologic resection, trauma, or large cystic lesions, remains a major challenge in Oral and Maxillofacial Surgery. Microvascular free tissue transfer has emerged as the gold standard for restoring orofacial continuity, function, and facial aesthetics.Fibular free flap (FFF), Subscapular system free flaps (including lateral scapular border flaps [LSBFs] and Scapular tip free flaps [STFFs]), iliac crest free flap (ICFF), and radial forearm osseous free flap (ROFF) are amongst the contemporary choices for reconstruction. Anatomic reliability and presence of sufficient vascularized bone, project fibula as an unrivaled flap. Abundant bone stock, least donor site morbidity favour Scapula as a osseocutaneous flap. Although each has their specific merits & demerits, prognostic demarcation of application is crucial. The aim of this study is to compare the outcomes of Oro-facial reconstruction using microvascular free fibula flaps and scapula flaps including assessment of postoperative complications, donor-site morbidity, management of complications, requirement for secondary procedures, and overall graft longevity.