The outline of the platysma flap is initially made as an. The use of myocutaneous flaps has resulted in improved methods for reconstruction involving the head and neck area. Flap is a mass of tissue contain or composed of skin, subcutaneous tissue and muscle and they are two types, axial pattern flap with good arterial and venous blood supply or random flap based on. Platysma musculocutaneous flap for reconstruction of. Its flap may be used as superiorly, inferiorly or posteriorly based. The role of the pectoralis major myocutaneous flap pmmf in head and neck reconstruction is challenged recently due to its natural drawbacks and the popularity of free flaps. The flap is oriented in the mandibular cheek region. The platysma flap may be used to close defects on the lower face, buccal mucosa, and floor of mouth. Fabio santanelli, di pompeo dillasi, sapienza, university of rome, school of. Laryngeal reconstruction by platysma myofascial flap after. The results of treatment of 36 patients tumour excision plus bilateral neck dissection and post.
The platysma myocutaneous flap for intraoral reconstruction was introduced in 1978. The scalp visor flap offers a simple but extremely versatile tool for use in midfacial reconstruction, especially in the male, providing neolip tissue, a moustache and a beard. The advantages of this flap are the proximity to the surgical area, and the fact that the skin island pedicled by platysma. The platysma myocutaneous flap oral and maxillofacial surgery. Platysma muscle cutaneous flap for large defects of the. It is reinforced with several sutures through platysma. Visor flap for total upper and lower lip reconstruction. This is the first report of a simultaneous total upper and lower lip reconstruction using a scalp visor flap. The role of the pectoralis major myocutaneous flap pmmf in head and neck. The incision outlines of the submental flap, platysma myocutaneous flap and the.
The platysma myocutaneous flap has enjoyed limited popularity despite its versatility, dependability, and ease of harvesting. Submental artery island flap vula university of cape town. Reconstruction of the posterior wall of the pharynx using a myocutaneous platysma flap. Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects 5 skin paddle up to the mandible, leaving the platysma down. Pdf reconstruction of the posterior wall of the pharynx. The platysma flap has often been used for reconstructions of the head and neck, but the arterial anatomy of the platysma. The platysma myocutaneous flap was introduced for intraoral reconstruction in 1978. Methods total 65 patients were included in this study from march 2005 to december 2012. Platysma musculocutaneous flap for reconstruction of trachea in esophageal cancer harutsugu sodeyama, md, kiyoshi matsuo, md, katsuhiko ishizaka, md, chiharu takahashi, md, reiko hayashi.
Platysma myocutaneous flap its current role in reconstructive. Twenty patients were treated for intraoral epidermoid carcinoma with a singlestage reconstructive technique using a myocutaneous flap based on the platysma muscle. Minimal incision rhytidectomy short scar face lift with. The smas flap was elevated with the orbicularis oculi flap and the platysma flap. It is a versatile, portable, and thin flap, is easy to perform, and can be obtained during neck dissection, with a primary closure of the donor site. Composite platysmaplasty and closed percutaneous platysma. Angiographic study of the platysma, abstract background. Large area of the skin from the inferior part of the neck can be harvested for defects of the cheek. It is obvious that myodermal platysma flap is a little bit thicker than platysma myofascial flap. Before flap harvesting the anticipated intraoral defect is measured. The term platysma and anatomy was used to search pubmed and scopus, producing 394 and 214 papers, respectively. The muscle was taken with the forceps at the spot where.
Platysma myocutaneous flap for reconstruction of intraoral. The objective of this paper is to show that platysma flaps have good results and should be an alternative in reconstructive surgery for oral tumors when microsurgery is not possible. In selected cases, the flap will extend to the oropharynx. The composite flap was pulled by the surgeon using a kocher or allis clamp, taking the anterior border of the incised platysma attached on the flap. A platysma flap is elevated usually 4 to 8 cm until it is adequately mobilized to suture to the mastoid periosteum. The mucosal layer and the vermilion are reconstructed with a rotational flap. Vertical platysma myocutaneous flap that sacrifices the. High superficial musculoaponeurotic system facelift with. The aim of the study is to present our experience using vertical pmf. The platysma myocutaneous flap, operative techniques in. The platysma myocutaneous flap offers an excellent alternative for reconstructing.
Letters to editor taking care not to damage the tracheal wall. After release of the zygomatic and masseteric retaining ligaments in the subsmas plane and dissection. It is a random flap comprising skin, subcutaneous fat, superficial neck veins, and platysma muscle. The skin and the platysma muscle fibers, which run vertically, are incised and turned 90 degrees, so the edges of the platysma fibers are sutured to the edge of the residual orbicularis. All of them were reconstructed with a platysma flap after neck dissection. Platysma myocutaneous flap is easy to harvest, thin and pliable, promoting threedimensional reconstruction, and there is a limited donor site morbidity with primary closure of the neck. Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. Complete neoglottic closure and acceptable voice quality were obtained by platysma myofascial flap. Cervicofacial flaps for head and neck reconstruction vula.
The following 4 platysmaplasty maneuvers were each performed on 4 hemifacesnecks. Platysma myocutaneous flap for oral cavity reconstruction. Open access guest editorial kummoona platysma muscle. Vocal function was assessed by videolaryngostroboscopy and subjective and objective voice analysis before and after surgery. The surgical procedure and flap design were described. A plane was created between the skin and platysma on both sides laterally keeping the platysma intact. This article presents two versions of the platysma myocutaneous flap, which is a reliable, axial pattern, pedicled flap capable of providing. The advantages of this flap are the proximity to the surgical area, and the fact that the skin island pedicled by platysma muscle is easily harvested and transplanted to the defect. Most authors who described the technique used a superiorly based flap, elevated the skin flap to fully expose the platysma, and ensured a minimum muscle.
The advantages of platysma flap include good color match, easy access to the donor site in the same operative field with minimum morbidity of donor site, ease. Usefulness of platysma muscle flap following superficial. Our experience of using a vertical platysma myocutaneous flap in a group of patients who underwent reconstruction after t2staged oral cancer surgical resection associated with neck dissection is. Biologic basis of deepithelialized transverse platysma. On the other hand, if the dermal and fatty tissue remains over the platysma muscle after deepithelialization, the myodermal flap is a more accurate term. Original article, report by ear, nose and throat journal. It includes the delicate superficial cervical fascia just deep to skin that envelopes the platysma. The platysma muscle flap, which is a reliable local flap. In cases in which the surgical defect is small and the options for free flap use are limited, the platysma myocutaneous flap is a viable option. In this article, we describe 12 consecutive patients who underwent platysma flap. The plane of elevation should include the sternocleidomastoid fascia, as. This provides a fixed suspension of the platysma to contour the jaw line. Submental versus platysma flap for the reconstruction of. Pectoralis major myocutaneous flap for head and neck.
This reconstruction technique was chosen because of the poor. Research data language editing scientific editing nature. Pdf vertical platysma myocutaneous flap reconstruction. Vertical platysma myocutaneous flap that sacrifices the facial artery. Useful for grade 4 trismus, in defects involving large areas of cheek lining and adjoining areas like the palate. Research open access vertical platysma myocutaneous flap that sacrifices the facial artery and vein zhenning li1,2, ruiwu li1,2, fayu liu1,2, qigen fang1,2, xu zhang1,2 and changfu sun1,2 abstract background.
Open access guest editorial kummoona platysma muscle flap. Platysma myocutaneous flap for patch stricturoplasty in. It includes the delicate superficial cervical fascia just deep to skin that envelopes the platysma and muscles of. However the limitations for use of the platysma myocutaneous flap. The posteriorly based platysma flap in oral and facial reconstruction. Platysma myocutaneous flap for patch stricturoplasty in relieving short and benign cervical esophageal stricture yidan lin, md, yaoguang jiang, md, ruwen wang, md, taiqian gong, md, and jinghai. The platysma flap is an attractive reconstructive option and offers several advantages. The platysma myocutaneous flap for oral cavity reconstruction kevin h. Turnover platysma flaps also correct such a deformity.
Role of platysma muscle flap in depressed scars of neck. Health, general cell research cytological research. These patients received surgical reconstruction of platysma flap and submental flap. This flap receives its blood supply primarily from branches of the a. Pdf on sep 1, 2011, nikhil panse and others published platysmal book flap for tracheostomy scars find, read and cite all the research you need on researchgate. The platysma is a superficial muscle that overlaps the sternocleidomastoid it is a broad sheet arising from the fascia covering the upper parts of the pectoralis major and deltoid.
Free flaps, particularly the radial forearm flap, provide excellent options for intraoral reconstruction of surgical defects. Its easy accessibility to the oral cavity allows for reconstruction of various intraoral areas such as buccal mucosa, floor of mouth and tongue. Research open access vertical platysma myocutaneous. Pectoralis major myocutaneous flap for head and neck defects in. The platysma myocutaneous flap for oral cavity reconstruction. Neurotized free platysma flap for functional eyelid. On the basis that the platysma muscle flap has a reliable arterial blood supply uehara et al. Platysma myocutaneous flap for intraoral defects jama.
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