Platysma myocutaneous flap - its current role in reconstructive surgery of oral soft tissue defects

Abstract

Reconstruction of oral soft-tissue defects following resection of oral carcinomas can be achieved using various techniques including microsurgical tissue transfer. However, there seems to be a role for regional or local flaps. Small to medium-size defects can be functionally reconstructed with the platysma myocutaneous flap as an excellent choice particularly in medically compromised patients not being eligible for free tissue transfer. The present paper reviews the indication, surgical technique, and complications following reconstruction of defects of the oral cavity with the platysma myocutaneous flap.

Keywords: Functional reconstruction; Head and neck neoplasms; Oral carcinoma; Platysma myocutaneous flap.

Fig. 1

The intraoperative site with incision of the skin island during harvesting of a cranially pedicled platysma myocutnaeous flap.

Fig. 2

Following an apron-type incision a skin flap will be dissected up to the mandible leaving the platysma muscle with the skin island down.

Fig. 3

Intraoral view of a cT2 carcinoma of the left lateral tongue border in a 75-year old woman (A). Intraoperative site following transoral resection of the carcinoma (B). A pedicled platysma myocutaneous flap is dissected (C) and rotated superiorely in to the intraoral defect of left tongue (D). Intraoperative site immediately after defect coverage of the left tongue border shows well vascularised pedicled platysma flap (E).

Fig. 4

Cervical skin with acceptable scar of the lower neck one year after surgery.

Fig. 5

Intraoral situation one year after reconstruction using platysma myocutaneous flap with well vascularised skin island and unrestricted tongue mobility.