Platysma Myocutaneous Flap Research Articles

Reconstruction of circumferential defect of the hypopharynx: experimental studies and clinical application of a new method.

Reconstruction of circumferential defect of the hypopharynx is a challenging problem in head and neck surgery. Reconstruction with a totally tubed pectoralis major myocutaneous flap (PMMCF) has been advocated in recent years, but this procedure has the disadvantage of excessive bulkiness. In order to solve this problem, the author experimented with a partially tubed platysma myocutaneous flap and an inner surface of apron skin flap of the anterior neck in the reconstruction of the circumferential defect of the hypopharynx in ten dogs. Subsequently, the same surgical technique using PMMCF instead of the platysma myocutaneous flap was used for reconstruction following total laryngopharyngectomy in eight patients. The new partially tubed flap was successful in solving the problem of excessive bulkiness of the totally tubed PMMCF.

The myocutaneous platysma flap for the reconstruction of intraoral defects after radical tumour resection

After performing 54 myocutaneous platysma flaps for reconstruction of intraoral defects following tumour surgery, the results, with reference to the postoperative outcome, are presented. Interest is focused on the anatomical basis of the flap's pedicle and its relevance for the indication of this method.

Secondary pharyngeal reconstruction after pharyngolaryngectomy using two platysma myocutaneous flaps

Secondary pharyngeal reconstruction after pharyngolaryngectomy using two platysma myocutaneous flaps

Reconstruction of the chin-lower cheek complex with a platysma myocutaneous flap

About 100 years ago, the Austrian surgeon Gersunyl used a flap of neck skin with the underlying platysma muscle to close a through and through defect of the cheek. To our knowledge this is the earliest recorded use of the superiorly-based platysma myocutaneous flap. Thirty years later, Cole2y3 further demonstrated the usefulness of the flap to correct intraoral defects and shortly thereafter Kanaver used the flap to fill a soft tissue defect of the chin region and to treat syphilitic osteomyelitis of the mandible. In the 195Os, several head and neck cancer surgeons described cervical skin flaps to reconstruct defects of the chin and lower cheek.5p6 DesPrez and Kiehn7 modified the apron flap (cervical skin flap) by de-epithelializing its proximal portion and transposing the distal “paddle” to reconstruct the oral lining: in essence, they raised a large, superiorly-based platysma myocutaneous flap. Martin8 and Ellis9 suggested that the muscle be included in neck skin flaps elevated during radical neck dissection. The blood supply of the neck and skin was then studied in superiorly-based platysma myocutaneous “skin-paddle” flaps used to reconstruct intraoral defectslo and in systematic dissections and injection studies.” Cannon et al.12 reported that the one-stage platysma flap reconstruction was highly useful in 22 patients with intraoral

Reconstruction of soft tissues of the chin and lower lip region following excision of a basal cell carcinoma

A rather unusual case of basal cell carcinoma of the labio-mental fold area is presented where it was possible to preserve the vermilion of the lower lip after wide excision. This made reconstruction with bilateral nasolabial flaps and a platysma myocutaneous flap possible. Thus the sensitivity of the lower lip could be partly preserved, a competent lip seal obtained, microstoma avoided and a good vestibulum reconstructed.

Platysma myocutaneous flap revisited.

The platysma myocutaneous flap has seen limited application in the reconstruction of head and neck defects over the past decade. There are anatomical and physiological reasons for this. There has been an emphasis on the anatomical vascular supply and method of preparation of the platysma myocutaneous flap and its use in the oral cavity. This article emphasizes the use of this flap for reconstruction of defects of the base of tongue, hypopharynx, lateral pharyngeal wall, and supraglottis. The criteria for selection of the platysma myocutaneous flap as a method of reconstruction, and the limitations, are outlined. New variations of harvesting the flap based on randomized muscular support are described. Specific complications as seen in our group of patients add certain precautions in the use of the platysma myocutaneous flap.

Reconstruction of the anterior oral cavity using the platysma myocutaneous island flap.

The platysma myocutaneous island flap has demonstrated high versatility and reliability when used to close defects in the oral cavity in a series of ten patients. The surgical technique for this one-stage reconstructive procedure is described. The advantages and disadvantages of this flap, the results, and complications are discussed.

The cutaneous blood supply of the neck: relevance to incision planning and surgical reconstruction

Previous descriptions of the blood supply of the neck have been contradictory. Neck dissections were performed on 17 adult cadavers after perfusion with radio-opaque microfil silicone rubber compound. In four cadavers cervical incisions were created and flaps elevated prior to perfusion to help demonstrate vascular pathways.In all cadavers myocutaneous perforators were seen passing from the sternocleidomastoid, strap muscles, and trapezius to supply the dermal-subdermal plexus. Also, there were consistently identifiable branches of the superior thyroid, posterior auricular, occipital, facial and transverse cervical arteries, which supply both the platysmal vascular plexus and the overlying dermal-subdermal plexus. The dermal-subdermal plexus is continuous across the midline and this contralateral pathway is supplied chiefly from branches of the superior thyroid artery, facial artery, and myocutaneous perforators of the strap muscles. This information may be useful in the planning of cervical incisions and the design of platysma myocutaneous flaps.

Platysma myocutaneous flap for intraoral defects.

The use of myocutaneous flaps has resulted in improved methods for reconstruction involving the head and neck area. The platysma myocutaneous flap offers an excellent alternative for reconstructing appropriate oral cavity defects resulting from tumor ablation. It has certain advantages over other local or distant pedicled flaps and has been proved to be a reliable alternative for single-stage repair of these defects. The technique of this flap is described and a review of its use in six cases, including complications, is discussed.

Reconstruction of the oral cavity using the platysma myocutaneous flap.

Reconstruction of intraoral defects after tumor ablation has been accomplished by a variety of different techniques. A platysma myocutaneous flap for intraoral reconstruction is outlined and the surgical technique described. Nineteen of 22 patients in whom this flap was used healed without major complication. In selected patients, the platysma myocutaneous flap is a highly useful one-stage procedure to close defects of the oral cavity. It provides 50 to 75 sq cm of flap coverage. The flap thickness closely matches the thickness of the mucosa of the oral cavity. The donor site is closed primarily with little or no cosmetic defect.

Platysma myocutaneous flap for intraoral reconstruction

Fourteen patients were treated for intraoral epidermoid carcinoma with a single stage reconstructive technic employing a myocutaneous flap based upon the platysma muscle. This flap carries on its distal tip a portion of isolated cervical skin to be used for intraoral replacement of the resected tissue. The flap has proved to be highly reliable and has significant benefits over many other technics commonly employed for head and neck reconstruction.

Pilonidal Sinus and Cyst

The present study was performed to demonstrate and evaluate the effectiveness of the Platysma Myocutaneous Flap in conjunction with MacFee's cervical incision (MacFee, 1960) for reconstruction after oral cancer excision. Ten squamous cell carcinoma cases were provided for postoperative evaluation of tongue movement and aesthetic problems of the cervical skin. It was found that the thickness of the skin island was adequate for covering the oral defects and was not a hindrance to proper postoperative function. MacFee's incision improved the condition of the scar caused by flap elevation. The procedure for preparing the muscle pedicle beneath the cervical skin tunnel was carried out without much difficulty by carefully preparing the surgical field.