English

Abstract

Case report A 23-year-old woman had a recurrence of malignant schwannoma in her right neck. After wide resection of the tumour and partial resection of trapezius muscle (Figure 1), a flap was designed according to the size and shape of the defect (Figure 2). Harvesting of the flap was performed by making an incision along the length of the latissimus dorsi muscle. After dissection down to muscle, the flaps were elevated anteriorly and posteriorly, exposing the entire muscle. The muscle was then divided from its attachments and elevated to the level of its thoracodorsal pedicle. The subcutaneous tunnel was made from the insertion of the muscle to the neck defect anterior to the axilla and the muscle passed through (Figure 3). The donor-site defect is closed primarily. Closed suction drains are employed at the donor and recipient sites, but not within the tunnel created to pass the flap pedicle (Figure 4). After surgery, the arm is kept flexed across the chest for seven days.