The Posterosuperiorly Based Platysmal Myocutaneous Flap: The Underutilized Reconstructive Option

Abstract

The platysmal myocutaneous flap has shown promising results for the reconstruction of defects in the head and neck region. It has been successfully used for the reconstruction of the defects over the cheek, floor of the mouth, buccal mucosa, tongue, lower lip, mandibular alveolus, hypopharnx and supraglotic larynx. The posteriorly and the superiorly based platysmal flaps have a wide range of applicability in the reconstruction of intraoral defects. In the present series we have used a posterosuperiorly based platysmal flap which has shown encouraging results. It was also found that leaving the base of the mandible intact helps in maintaining the periosteal blood supply which further contributes to the survival of the flap. The thinness, arc of rotation, pliability and ease of availability of the platysmal myocutaneous flap gives the reconstructive surgeon an additional option, especially when a microvascular flap is not feasible.

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“…Borrowing from a technique for mandible reconstruction, a left superiorly-based platysmal flap was performed to restore coverage of exposed mandibular plate and address the microstomia. 11 The flap is based on the submental artery. The superior portion of the platysma muscle was identified through an existing incision and the inferior portion after dissecting toward the clavicle.…”