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.

Platysma myocutaneous flap revised in the free flaps era: clinical experience in 61 patients

“…Reconstruction of oral cavity defects following radical surgery for SCC can be achieved by a variety of techniques [1][2][3][4][5][6] . The choice is influenced by several factors, including size and location of the defect, patient characteristics, donor site morbidity, and functional and aesthetic outcomes [1][2][3][4][5][6][7][8][9][10][11][12][13] . Nowadays microvascular free flaps, for instance anterolateral tight (ALTFF) and radial forearm (RFFF), are considered the gold standard among head and neck surgeons for restoration of oral defects.…”

“…However, in some particular situations, as in compromised patient in which a time-consuming procedure is at high risk, a pedicled flap could be a better choice [9][10][11][12][13] . Moreover, in small defects the donor site morbidity and aesthetic outcomes have to be taken into account 2,4 . Many loco-regional pedicle flaps are available for head and neck reconstruction [9][10][11][12][13][14][15] ; among these, the MPF presents some advantages, for instance appropriate thickness, ideal pliability, wide arch of rotation (almost 180°), and good colour match with facial skin in case of external reconstruction.…”

“…Many loco-regional pedicle flaps are available for head and neck reconstruction [9][10][11][12][13][14][15] ; among these, the MPF presents some advantages, for instance appropriate thickness, ideal pliability, wide arch of rotation (almost 180°), and good colour match with facial skin in case of external reconstruction. Furthermore, donor site morbidity is low, and it is easy to access in the same operative field, reducing the operation time [1][2][3][4][5] . Consequently, MPF can be an excellent choice in reconstruction of oral cavity, oropharynx, and low face defects of small to medium size (15-75 cm 2 ) [1][2][3][4][5][6][7][8] ; however, some anatomical and oncological controversies on the use of this flap are still debated.…”

Sandwich flaps as a feasible solution for the management of huge mandibular composite tissue defects

“…In heavily irradiated patients with consequent wound healing disorders, or patients with poor blood vessels and/or medically compromised patients, local pedicle flaps such as the platysma myocutaneous flap, supraclavicular island flap or deltopectoral flap (DPF) can be used for extraoral, cervical and intraoral coverage (Bakamjian 1965;Pallua and Magnus Noah 2000;Tosco et al 2012;Eckardt 2013). They combine good aesthetic and functional results along with less effort and donor site morbidity and can therefore be a good alternative to free flaps.…”

Reconstruction of Soft Tissue Defects with Regional Flaps

“…It can be attached caudally or cranially [ 74 ] and is useful for defects of the neck and lower third. This flap can be used to repair defects of the anterior floor of the mouth [ 75 , 73 ], tongue, and pharynx [ 76 ]. It can be used as an alternative to the superficial muscular-aponeurotic system flap after parotidectomy [ 77 ].…”