Introduction: Reconstructing defects following maxillary resections represents a challenge for the reconstructive surgeon because of the critical role played by the maxillary skeleton in facial function and aesthetics. Actually in large oro-maxillofacial defects the first choice is the microsurgical reconstruction with osseous, osteocutaneous or osteomyocutaneous distant flaps.

Objective: The purpose of this clinical study was the evaluation of the scapula osteomyocutaneous flap based on the angular artery for maxillary reconstruction.

Methods: Between 2000 and 2010 we treated 68 patients with maxillary defects reconstructed with free flaps. In 6 cases we used a scapular osteomyocutaneous free-flap based on the angular artery and vein.

In 4 cases the defects were represented by lower maxillectomy, in 2 cases we reconstructed a sub-total maxillectomy with preservation of the orbital floor.

All the patients were postoperative evaluated with 3D-Tomography and Ortopanthomography.

Results: All the flaps were harvested and transplanted, we had no immediate or postoperative mayor or minor complications. In all the patients we could harvest a pedicle long enough (mean 12–14 cm) to reach neck vessels for anastomosis without tension and without artery or vein grafts.

The triangular shape of the flap allowed us to recreate the natural palate shape without performing any other osteotomy and we used the muscle to recreate the mucosal lining.

All the patients underwent physiotherapy in the postoperative to improve the recovery of the arm and shoulder.

Conflict of interest: None declared.