Thoracoacromial Artery Research Articles

A radial artery originating from the thoracoacromial artery.

The purpose of this case report is to report a rare vascular variation in the upper limbs because of its clinical importance and embryological implication. During the educational dissection of a 73-year-old Korean male cadaver`s right upper limb, we found a variant branch which is originated from the thoracoacromial artery. The variant branch from the thoracoacromial artery ran to the distal forearm in the deep fascia. Because it finally coursed like the radial artery in the forearm and the palm, we defined the variant artery as superficial brachioradial artery (SBRA). In the cubital region a little below the intercondylar line, the brachial artery gave off a small communicating branch to SBRA, and continued as the ulnar artery. We reported this unique variation and discussed its clinical and embryological implication.

A modified pectoralis major myocutaneous flap technique with improved vascular supply and an extended rotation arc for oral defects: A case report

The pedicled pectoralis major myocutaneous (PMMC) flap is versatile, and is widely used for the treatment of surgical defects following oral cancer resection. Although free-tissue transfer of a vascularized free flap is often preferred, the clinical benefits of the PMMC flap should not be overlooked. The conventional technique of harvesting a PMMC flap involves a single vascular supply from the pectoral branch of the thoracoacromial artery. However, this approach compromises the distal skin island of the flap, and requires an indirect blood supply via communicating vessels, which increases the potential risk of partial distal flap necrosis. When harvesting a PMMC flap for oral and maxillofacial reconstruction, preservation of the lateral thoracic artery and use of the subclavian route are alternatives that ensure sufficient blood supply and an increased rotation arc. Such an approach enables the harvesting of a PMMC flap that can reach the entire oral cavity, including the infraorbital region, palate, middle pterygopalatine fossa and nasopharynx, with no risk of vascular insufficiency to the distal skin island. In conclusion, the technique described in the present study was able to improve the blood supply of the distal PMMC flap and increase its rotation arc.

Neurovascular distribution within the abdominal head of the pectoralis major muscle: Application to breast and flap surgery.

The abdominal head of the pectoralis major (AHPM) is important in cosmetic and flap surgeries. Few studies have reported on its neurovascular entry points and distribution patterns. We aimed to determine the entry points and distribution patterns of the neurovascular structures within the AHPM. Thirty-two hemithoraxes were dissected, and the distribution patterns of the neurovascular structures were classified into several categories. The neurovascular entry points were measured at the horizontal line passing through the jugular notch (x-axis) and the midclavicular line (y-axis). The AHPM was innervated by the communication branches of the medial pectoral nerve (MPN) and the lateral pectoral nerve (LPN) in 78.1% of the specimens and of the MPN without the communication branches in 21.9%. All the LPNs had communication branches, which could be classified as independent in 46.9% of the samples, with the MPN in 21.9%, and with the LPN in 9.3%. The blood supply of the AHPM was composed of branches from the lateral thoracic artery (LTA) in 62.5% of the specimens, the thoracoacromial artery (TA) in 15.6%, and the LTA with the TA in 21.9%. The mean distance of the entry point was 6.3 cm ± 1.3 cm lateral to the y-axis, 8.1 cm ± 3.3 cm below the x-axis in the nerves, 6.5 cm ± 1.2 cm lateral to the y-axis, and 8.6 cm ± 3.0 cm below the x-axis in the arteries. This study defined the average neurovascular entry point and distribution pattern in detail using standard lines to enable the AHPM to be better understood.

Head and neck reconstruction by using extended pectoralis major myocutaneous flap.

Pectoralis major flaps have been the workhorse in head and neck region reconstructions till date. However, pectoralis major flaps have disadvantages, including limitations regarding flap range and less stable blood flow than that in free flaps. Here, we report on the safe reconstruction to the oral cavity and neck area by using extended pectoralis major flaps. These flaps include both the normal vessels that feed pectoralis major flaps (the thoracoacromial artery and vein) and the lateral thoracic artery and vein to stabilize blood flow and expand flap survival area caudally. Eight patients who had undergone reconstruction with extended pectoralis major flaps after the resection of head and neck cancers from June 2009 to March 2013. In all cases, the pectoralis major flap was elevated with a vascular pedicle comprising the thoracoacromial artery and vein and the lateral thoracic artery and vein. No blood circulation disorders, such as ischemia or congestion, were observed after the flaps were elevated and moved to the resected areas. All flaps were sutured on without difficulty. The area the flaps were harvested from was closed in a single stage. No postoperative complications such as hematoma, abscess, or fistula were observed. Extended pectoralis major flaps have a wide range and more stable blood flow, so they are thought to be useful in situations in which free flaps cannot be used for a variety of reasons.

Tackling the axillary blind spot with PECS II

We read Blanco et al.'s description of the PECS II and serratus plane blocks 1, 2 with great interest. We would like to describe a possible new role of this novel interfascial plane block in vascular access creation. In our institution, axillo-brachial arteriovenous graft creation is usually performed under regional anaesthesia in order to avoid the risks of general anaesthesia in this group of patients with significant co-morbidities. We routinely administer an ultrasound-guided supraclavicular block together with superficial local anaesthetic infiltration near the axilla to block the intercostobrachial nerve. However, we have observed that this technique is frequently inadequate for extensive axillary dissection, requiring either intra-operative local anaesthetic supplementation or conversion to general anaesthesia. Recently, we started performing a variation of Blanco et al.'s PECS II block technique 3, 4 in combination with a supraclavicular block for upper limb vascular access creation that extends to the axilla. The results so far have been encouraging, and we would like to share our experience. We used ultrasound (FUJIFILM SonoSite M-Turbo®), with a linear array transducer (13-6 MHz) and 22-G, 50-mm Stimuplex® needle (B. Braun Medical Inc., Melsungen, Germany). The patients were placed in the supine position with standard monitoring. The ultrasound probe was placed below the outer third of the clavicle, in a sagittal plane, with pectoralis major and minor, serratus anterior muscles and thoracic rib in view. The needle was inserted in-plane from medial to lateral, in a cephalo-caudad fashion, targeting the fascial plane between the pectoralis minor and serratus anterior muscles at the third rib, taking care to avoid puncturing the thoracoacromial artery and pleura. We used a variation of local anaesthetic volumes from 10 ml to 20 ml ropivacaine 0.5%, with a further 15–20 ml to block the brachial plexus via a supraclavicular approach under real-time ultrasound guidance. This alternative technique provided satisfactory anaesthesia in our very limited case series of three patients, with surgical duration varying from 2 h to 5 h. No additional local anaesthetic supplementation by the surgeon was required despite significant dissection into the axillary fossa. The procedure was well received by both patients and surgeons. Our initial experience with this interfascial plane block for anaesthesia in the axillary fossa has been promising. We are in the midst of conducting a randomised controlled trial to determine the efficacy of the modified PECS II block in patients undergoing arteriovenous graft creation surgery.

Coracoacromial ligament section under ultrasonographic control: A cadaveric study on 20 cases

IntroductionThe coracoacromial ligament is a complex anatomical structure involved in the development of subacromial impingement; treatment is founded on sectioning the ligament, with or without associated arthroscopic acromioplasty and debridement. HypothesisComplete coracoacromial ligament section can be performed under ultrasound, without lesion to surrounding structures. Materials and methodsThe coracoacromial ligament was sectioned on the coracoid side, under ultrasound navigation, in 10 cadavers donated to science: i.e. 20 shoulders. After ultrasound location of the shoulder structures, sectioning was performed with a skin incision at the level of the deltopectoral sulcus. Secondary surgical control checked conservation of the acromial branch of the thoracoacromial artery, and the quality of the procedure. ResultsMean surgery duration was 18.5 minutes (±5min). Seventeen sections were complete (85%). Artery location was hampered by the impossibility of using Doppler on these cadavers, yet even so there were only 2 vascular lesions. There were no accidental rotator cuff or cartilaginous lesions. ConclusionThis relatively non-invasive technique is quick and less heavy than open surgery, opening up new treatment perspectives. It could be indicated in coracoid and subacromial impingement before opting for surgery, or as a complement to surgery. It does, however, involve a learning curve and requires solid ultrasound skills.

Thoracoacromial artery perforator flap based on the clavicular branch: A new option in regional reconstruction

AimThoarcoacromial artery‐based perforator flaps are rarely used in clinical practice, especially for the reconstruction of head, neck and axillary regions. In the present study, we present a case with an anterior chest wall soft tissue defect that was reconstructed using a thoarcoacromial artery‐based perforator flap based on the clavicular branch.Patients and MethodsA 65‐year‐old male patient presented with an anterior chest wall defect secondary to tumour resection, which was reconstructed using a thoarcoacromial artery‐based perforator flap.ResultsThe patient healed successfully without any early or late complications. To date, he is still followed up by plastic surgery and oncology departments.ConclusionAlthough there may be variable consistencies, the thoracoacromial artery perforator flap could be a good alternative to pectoralis major flap for upper chest wall, axilla and neck reconstructions.

Anatomical study of pectoral nerves and its implications in surgery.

This anatomical study of the pectoral nerves and their innervation is to provide detail informations on the pectoral nerves and their variations in their course, to guide the cosmetic and plastic surgeons for their easy intra operative localization and to improve the understanding of the pectoral muscle innervation, which is very much required during breast reconstruction after modified radical mastectomy (MRM) in breast cancer; axillary dissection; removal of the pectoralis minor muscle, and in harvesting the pectoralis major for myocutaneous head and neck island flap surgeries. A total of 50 pectoral region specimens (both right and left sided) from 25 embalmed adult human cadavers (20 female & 05 male) were studied by dissection method. The data were tabulated in Microsoft excel and analysed by using Statistical Package for Social Science (SPSS 17(th) version). Mean, Proportion, Standard deviation and Unpaired t-test were applied for analysing the data obtained. In all the specimens, the medial pectoral nerve pierces the pectoralis minor muscle; but as a single trunk in 76%, and as dividing branches in 34% specimens. The extent of costal attachment of the pectoralis minor muscle found to be less than 6.0 cm in cases of the medial pectoral nerve piercing the pectoralis minor muscle as a single trunk. The medial pectoral nerve after piercing the pectoralis minor, ramify within the muscle supplying it, finally runs along the lateral aspect (lower border) of the pectoralis minor muscle to supply the lower portion or distal segment of the pectoralis major muscle. Similarly, the lateral pectoral nerve runs along the upper border (medial aspect) of the pectoralis minor muscle (98%) and then runs under surface of the pectoralis major muscle along with the pectoral branch of thoracoacromial artery, supplying the upper portion or most of the proximal 2/3(rd) of the pectoralis major muscle. Therefore, when the pectoralis minor muscle is removed in a modified radical mastectomy or during dissection between the two muscles, there is partial denervation of the pectoralis major muscle with partial atrophy and decrease in muscle mass. If the lateral pectoral nerve also injured along with the medial pectoral nerve, it can result in total denervation of the pectoralis major muscle with severe atrophy and fibrosis. In breast augmentation implants placing behind the pectoralis major muscle, it is found to be more advantageous if the pectoralis major muscle is partially denervated for the better projection and contour. The distance of the branches of the medial pectoral nerve and the lateral pectoral nerve in the pectoral muscles from the lateral margin of the sternum being 8.8-10.8 cm and 5.8-10.2 cm respectively. The proximal segment or upper portion of the pectoralis major muscle has got separate independent vascular and nerve supply; therefore, it can be safely used as a myocutaneous flap in surgeries of head and neck or anterior chest wall.

Complete Avulsion of Brachial Plexus with Associated Vascular Trauma

Vascular trauma associated with brachial plexus injury affects the selection of reconstructive procedures. Often, there is a paucity of appropriate recipient vessels with adequate blood flow for functioning free muscle transfer. The presence of associated vascular injuries of the subclavian or axillary artery is considered a contraindication to the double free muscle technique. The authors hypothesized that vascular repair of subclavian or axillary artery trauma might not be necessary for successful reconstruction using the double free muscle technique, provided that the recipient arteries for functioning free muscle transfer (e.g., thoracoacromial and thoracodorsal arteries) are found to be patent on preoperative angiography. The authors investigated the pathway of collateral circulation and potential recipient vessels for functioning free muscle transfer reconstruction in 20 brachial plexus injury patients associated with subclavian or axillary artery trauma using multidetector-row computed tomographic angiography. Based on these findings, the authors restored upper extremity function using the double free muscle technique without surgical repair of the injury to the major vessel in three patients. The suprascapular artery was the major stem artery for collateral circulation, and the circumflex scapular and subscapular arteries were major reentry arteries. The authors successfully used the thoracoacromial and thoracodorsal arteries as the recipient vessels for functioning free muscle transfers in the double free muscle technique. The preliminary functional outcomes of all three cases were satisfactory. This study demonstrates the feasibility of double free muscle technique reconstruction in brachial plexus injury patients, without actual vascular repair for the associated subclavian or axillary artery trauma. Therapeutic, IV.

The lateral thoracic artery revisited

Although the variations in the origin of the branches of the axillary and subclavian arteries have been well documented, little information regarding the highly variable lateral thoracic artery (LTA) is available. Descriptions of the LTA variations may prove useful during procedures of the lateral aspects of the thorax such as reconstructive plastic surgery and modified radical mastectomy. The aim of this study was to examine the anatomy of the LTA and offer an accurate account of its variability. The entire course and distribution of the LTA was examined in 420 formalin-fixed adult human cadavers. The LTA was found in 96.7 % of the specimens, showing great morphological variability and classified into six types according to its origin. The most common type was where the LTA arose from the thoracoacromial artery (Type I 67.62 %). In decreasing order of incidence were origins from: the axillary artery (Type II 17.02 %), the thoracodorsal artery (Type III 5 %), and the subscapular artery (Type IV 3.93 %). Additionally, multiple LTAs were present (Type V 3.09 %) and complete absence of LTA (Type VI 3.33 %) was observed. Despite variations in origin of the vessels, our dissections demonstrated that the ultimate tissue distribution of the LTA remained typical in the vast majority of the specimens and descended on the lateral border of the pectoralis minor. Our results illustrate the need for re-evaluation of the branches of the thoracoacromial artery with possible consideration that the LTA arises from it, instead of directly from the axillary artery. We hope that the information supplied by this study will provide useful information to anatomists and surgeons alike.

Development of the Pectoral Perforator Flap and the Deltopectoral Perforator Flap Pedicled With the Pectoralis Major Muscle Flap

Because thinning of the pectoralis major myocutaneous flap is impossible due to blood circulation, it is difficult to produce thin flaps. Although the pectoral flap and the deltopectoral flap are the best flaps that provide a highly desirable color-texture match to facial skin, their reach is restricted and they require resection in 2 stages. The purpose of this paper is to develop a new method of elevating a flap and to resolve these problems. First, include the third intercostal perforating branch of the internal thoracic artery in the skin paddle and, outward therefrom, design a skin paddle of the pectoral flap in accordance with the shape of the defect. After a skin incision along the design, elevate the pectoral flap pedicled with the third intercostal perforating branch. Then, after cutting the third intercostal perforating branch at the lower surface of the pectoralis major muscle, harvest the approximately 5- to 6-cm-wide pectoralis major muscle in the lateral direction. In doing so, it is important to include in the harvested muscle body of the pectoralis major muscle the muscular branch of the third intercostal perforating branch, the branch of thoracoacromial artery, as well as the true anastomosis of both. Thereafter, elevate the entire flap, with the thoracoacromial artery for vascularization, and move it to the head and neck region via the subclavian route. In this way, the pectoral perforator flap pedicled with the pectoralis major muscle flap (PP flap) is elevated. As for the deltopectoral perforator flap with the pectoralis major muscle flap (DPP flap), after elevating the deltopectoral flap pedicled with both the second and third intercostal perforating branches of the internal thoracic artery, carry out the same flap elevation operations. The PP flap was used in 4 cases and the DPP flap was used in 1 case. In all cases, the flaps were completely grafted and quite satisfactory, functional, as well as demonstrating good cosmetic results. Unlike the conventional pectoralis major myocutaneous flap, the PP flap does not contain in its skin paddle the pectoralis major muscle and the mammary gland, making it possible to produce a thin flap. In addition, the development of this method has now substantially extended the reach of the flap, thereby making it possible for the PP flap to reach the oropharyngeal region and for the DPP flap to reach the frontal region at a single time. Originally, the skin over the precordium is relatively thin and flexible and provides a desirable color-texture match to facial and neck skin; therefore, it is believed that this method may serve as an extremely useful means in the future in the functional and cosmetic reconstruction of the head and neck region.

Unilateral Third Head of Biceps Brachii with Associated Neurovascular Variants in both the Upper Limbs of a Single Cadaver

During routine undergraduate dissection in the upper extremities of a 65 years old male cadaver in the department of Anatomy at Dr. PSIMS & RF, coexistence of muscular and neurovascular variants were identified .Muscular variations included presence of additional head(third) of biceps brachii in the left arm, accompanied with medially positioned median nerve in relation to brachial artery bilaterally . Teres minor muscle was not identified and the origin of long head of triceps brachii extended upto the lateral border of scapula on the left side. Both the medial cutaneous nerves of arm and forearm arouse from a single trunk bilaterally. In the right limb the axillary artery showed only four branches instead of six branches, with common trunk for thoraco-acromial and lateral thoracic artery and common trunk for subscapular and posterior circumflex humeral artery. Knowledge of coexistence of these variations would of profound importance surgically and clinically, especially in limb injuries and surgical repairs. DOI: http://dx.doi.org/10.3126/ajms.v5i1.7391 Asian Journal of Medical Science Vol.5(1) 2014 pp.81-85

Use of the deltoid branch-based clavicular head of pectoralis major muscle flap in isolated sternoclavicular infections

The pectoralis major (PM) flap is the workhorse flap for acute, sub-acute and chronic sternoclavicular infections (SCIs). Attempts at using only the clavicular head of the pectoralis major muscle (CPM), based on internal mammary perforators or the thoracoacromial artery, have been reported. We describe the harvest of a deltoid branch-based flap (CPM-DTA) and examine its use in managing a series of isolated, acute and sub-acute sternoclavicular infections. From 2007 to 2012, 28 subjects with SCI underwent PM flaps at our institution. Six were excluded for extensive chest wall involvement, and four were excluded from chronic osteomyelitis (5 months of infection or greater). Of the remaining 18 patients with isolated SCI, 12 underwent traditional PM flaps (Group-A), while six underwent CPM-DTA (Group-B). Features studied include age, gender, co-morbidities, culture, need for intra-operative extension of the sternoclavicular incision, postoperative complications, wound healing, time from infection onset to debridement, length of hospital stay, postoperative chest wall contour deformity and follow-up. Infections resolved and wounds healed in all patients following a single reconstructive procedure. Intra-operative need for extended incisions and postoperative ipsilateral anterior chest wall contour deformity are noted in all Group-A subjects but in no Group-B subjects. In patients with isolated, acute and sub-acute SCI, the CPM-DTA flap achieves effective wound closure while avoiding large sternal incisions and the morbidity associated with standard PM muscle harvest. Harvesting the CPM-DTA flap preserves the sternocostal head of the pectoralis major muscle and its thoracoacromial pedicle. This preserves the muscle for future flap use if necessary.

A study on axillary artery and its branching pattern among the population of West Bengal, India.

Variations in the branching pattern of the axillary artery have paramount importance among anatomists, surgeons and radiologists. A study was conducted on this topic in Kolkata, among the people of West Bengal, a state of India. The upper limbs of 70 cadavers were dissected bilaterally at the Department of Anatomy, Calcutta National Medical College, Kolkata, between 2008 and 2011. Among the study population, 52 cadavers (74.3%) were male and the rest were female, with average age 62.01 years (standard deviation = 6.58) and average height 1.59 meter (standard deviation = 0.096) respectively. The mean length of the axillary artery was 10.15 cm (standard deviation = 1.056). The superior thoracic, thoracoacromial and subscapular arteries were found to be constant branches of the axillary artery while the other branches showed considerable variations. Among those constant branches a high, significant correlation was found between the distance of origin of thoracoacromial artery from the outer border of the 1st rib and the length of the axillary artery, for the right and respectively the left upper limb of male cadavers. In females it showed a moderate, albeit significant correlation only. Similarly, the length of the axillary artery established a moderate correlation with the distance of origin of the superior thoracic and of the subscapular arteries on the right side of female cadavers. No other significant correlation was obtained.

Anatomic Variations in Branching Patterns of the Axillary Artery: A Multidetector-Row Computed Tomography Angiography Study

Anatomic variations in branching pattern of axillary artery (AxA) are common and typically involve subscapular artery (SsA) and posterior circumflex humeral artery (PCHA). Several skin and muscle flaps are based on the branches of AxA. Furthermore, these branches are frequently used as recipient vessels in functioning free muscle transfers for upper extremity reconstruction and in breast reconstruction. Accurate knowledge of the normal anatomy and variations in branching pattern of AxA is of significant clinical importance for the reconstructive microsurgeon. The purpose of this article is to report the variable branching pattern of AxA based on multidetector-row computed tomography angiography study of 62 upper extremities. The thoracoacromial artery consistently originated from the first or second part of AxA. The classic origin and branching patterns of SsA and PCHA were observed in 21 cases (33.9%). Anatomic variations of SsA and PCHA were observed in 41 upper extremities (66.1%). In addition to the classic pattern, five distinct variations were noted.

Thoracoacromial Artery Perforator Flap

Concerns and criticism have been reported on the feasibility and vascular reliability of the thoracoacromial artery perforator flap because of the inconsistent size of the pectoral branch of the thoracoacromial artery and its cutaneous perforators. The authors have investigated its vascular basis through a cadaver dissection and described their clinical experience in the surgical strategy, range of application, and indications for the thoracoacromial artery perforator flap. Twelve fresh human cadavers were dissected to define the anatomy of the branches of the thoracoacromial artery and their perforators and the anatomical landmarks for clinical application. Single pectoral branch perforators were injected to measure the extension of the thoracoacromial artery perforator vascular territory. A constant thoracoacromial artery perforator was present in the septum between the clavicular and sternocostal heads of the pectoralis major muscle in 21 of 24 hemichests. The mean caliber of the perforator was 0.7 mm and the mean length of the vascular pedicle was 7.1 cm. The territory of the thoracoacromial artery perforator flap extended up to the fourth intercostal space inferiorly. Between 2006 and 2011, the thoracoacromial artery perforator flap was used to reconstruct head and neck defects in seven patients. All patients healed uneventfully. The authors' studies provide evidence of the vascular supply and the clinical application of the thoracoacromial artery perforator flap. The recruitment of the chest skin through a thoracoacromial artery perforator flap resulted in an adequate color match, texture, and pliability for local adjacent defect restoration and for head and neck reconstruction. Therapeutic, IV.

Anatomical study of the communicating branches of cords of the brachial plexus and their clinical implications

The aim of this study was to investigate the occurrence and patterns of the communicating branches of cords of the brachial plexus (BPs). This study was performed with 50 fixed adult cadavers (all 100 sides). The BPs were exposed, the presence of the communicating branches of BPs were determined, measured, and photographed. The communicating branches were identified in 27 sides of the BPs. According to enthesis, the communicating branches between the medial and lateral cords (25 sides) were divided into five types. The most common branches connected the lateral cord with the medial root of the median nerve (16 sides). All the communicating branches between the lateral and medial cords obliquely crossed anterior to the axillary artery and passed below the thoracoacromial artery trunk. The distance of the communicating branch with the origin of thoracoacromial artery trunk was 1.60 ± 0.64 cm. The length, transverse diameter, and anteroposterior diameter of communicating branch were 1.67 ± 0.62 cm, 1.77 ± 0.63 mm, and 1.91 ± 0.34 mm, respectively. These anatomical data about the communicating branches will be helpful for surgeons who perform surgical procedures in the cervical and axillary regions.

A Unique Branching Pattern of the Axillary Artery: A Case Report

During routine dissection classes for under graduate students, we found a unique and unusual case regarding the anomalous branching in the third part of the axillary artery was terminated into subscapular arterial trunk, superficial brachial artery and deep brachial artery. The subscapular arterial trunk was origin of several important arteries as the circumflex scapular, thoracodorsal, posterior circumflex humeral, thoraco-acromial and lateral thoracic arteries. The deep brachial artery in the arm gave anterior circumflex humeral artery at the surgical neck of humerus, which terminated in the cubital fossa by dividing into radial and ulnar arteries. The superficial brachial artery gave two profunda brachii arteries, both of which passed through spiral groove, along with radial nerve and three muscular branches, to brachialis muscle. This variation is very rare. As per our knowledge, we did not find any literature which explained variations which were similar to this. The normal and abnormal anatomy of the axillary region has practical importance among vascular radiologists and surgeons and it should be known for making an accurate diagnostic interpretation.

Thoracoacromial artery perforators

Thoracoacromial artery perforators

A propeller flap based on the thoracoacromial artery for reconstruction of a skin defect in the cervical region: A case report

A propeller flap is useful for coverage of an adjacent skin defect without dissection back to source vessels and harvesting muscle tissues. The thoracoacromial artery is one of the vascular pedicles of the flaps for reconstruction in the cervical region. Use of a propeller flap based on the thoracoacromial artery has not previously been reported for reconstruction in the cervical region. We report a case in which a propeller flap based on the thoracoacromial artery was used for skin coverage after tumour resection in the cervical region together with an anatomical investigation. The propeller flap based on the thoracoacromial artery was harvested in the supine position, requiring no change in position after tumour resection. The skin defect was successfully reconstructed using the propeller flap based on the thoracoacromial artery with linear closure of the donor site. The propeller flap based on the thoracoacromial artery offers an alternative for reconstruction in the cervical region.