Vertical platysma myocutaneous flap that sacrifices the. In cases in which the surgical defect is small and the options for free flap use are limited, the platysma myocutaneous flap is. It includes the delicate superficial cervical fascia just deep to skin that envelopes the platysma and muscles of. The platysma myocutaneous flap has enjoyed limited popularity despite its versatility, dependability, and ease of harvesting. Platysma definition of platysma by medical dictionary. Reconstruction of fullthickness cheek defects using. 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. Platysmabased myocutaneous clavicular island flap for. This article is from pakistan journal of medical sciences, volume 30. Platysma is also a plant taxon synonym with podochilus, an orchid genus.
We analyzed the superiority and reliability of the flap. The platysma myocutaneous flap operative techniques in. Mean operation time of submental flap including flap harvesting 5. Platysma myocutaneous flap for intraoral reconstruction. Clinical reliability of radial forearm free flap in repair of. With the neck hyperextended the proposed skin paddle was outlined on the ipsilateral neck, below the inferior border of the mandible figure 1. The platysma myocutaneous flap, operative techniques in. From 2005 to 2012, 20 radial forearm flaps were used to repair the defects. In addition, it may be beneficial to include the external jugular andor the communicating veins in. The diverse indications described for the platysma myocutaneous. It is a broad sheet arising from the fascia covering the upper parts of the pectoralis major and deltoid. In this article, we describe 12 consecutive patients who underwent platysma flap reconstruction of various oral cavity and oropharyngeal defects. Superiorly based platysma myocutaneous flap was raised as described by gupta and used for reconstruction of the intraoral defects.
In this study, a different application of the platysma myocutaneous flap for the reconstruction of fullthickness cheek defects is presented. Platysma medical definition merriamwebster medical. The superior incision was made first and a plane superficial to the platysma muscle was dissected. It was used in four patients operated on under local. Platysma bands and ageing as a person ages, changes in the tone of the skin, especially in the neck, can occur. An early sign of ageing in the skin of the neck is the appearance of platysma bands, or ridges in the skin that can run the length of the muscle. This reconstruction technique was chosen because of the poor. 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. Pdf vertical platysma myocutaneous flap reconstruction. The technique described has provided an acceptable cosmetic and functional result.
This can be done through a single incision located underneath the. The platysma flap has often been used for reconstructions of the head and neck, but the arterial anatomy of the platysma itself has not been clarified. The surgical technique used was original and was based on the principle of auricular. Reconstruction of fullthickness cheek defects using platysma. The rate of complications is similar to other published series, and problems encountered were manageable using conservative methods with excellent functional and cosmetic outcomes. In cases in which the surgical defect is small and the options for free flap use are limited, the. Platysma myocutaneous flap for reconstruction of intraoral. Platysma myocutaneous flap for oral cavity reconstruction. Pdf vertical platysma myocutaneous flap reconstruction for. Platysma myocutaneous flap can be accomplished in a single stage owning many advantages in comparison with other flaps for patch stricturoplasty in relieving the short and benign cervical esophageal stricture ie, it is closer to the recipient site, thinner, pliable, and reliable. To compare the platysma flap with submental flap in terms of tumor and. Latysm anatomical considerations surface markings adjacent muscles vascular pattern motor nerve. At 40, sometimes all that is needed is to suture the platysma muscle back together in the middle and to remove the fat.
Recently, the number of thyroid surgery cases has been increasing. Platysma myocutaneous flap for intraoral reconstruction, am. 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. Request pdf the platysma myocutaneous flap reconstruction of the primary defect is an integral part of the surgical treatment of head and neck cancer. It has certain advantages over other local or distant pedicled flaps and has been proved to be a reliable alternative for singlestage repair of these defects. Role of platysma muscle flap in depressed scars of neck original. The platysma myocutaneous flap offers an excellent alternative for reconstructing appropriate oral cavity defects resulting from tumor ablation. Platysma myocutaneous flap for patch stricturoplasty in. Platysma myocutaneous flap for intraoral defects jama. Window defects involving 5, 10, or 15 rings and the whole anterior tracheal wall were produced in 3 different groups of animals.
The location where neurovascular structures entered the platysma muscle were expressed as the percentage distance standard deviation from the sternocleidomastoid muscle scm mastoid insertion to manubrium origin. Use of the platysma myocutaneous flap for cervical trachea. This article introduces our pioneer use of the platysma myocutaneous. The flap is oriented in the mandibular cheek region. The superior thyroid, facial, and lingual vessels were the major pedicles in eight of 14 57. These flaps are not only an alternative to microvascular flaps but they also an excellent reconstructive choice especially in cases where free tissue transfer cannot be carried out. The superior thyroid, facial, and lingual vessels were the major pedicles in 814 57. Platysma article about platysma by the free dictionary. Thanks to further refinements of microvascular techniques in the past three decades, transfer of a free flap is now a routine procedure.
The superiorly based flap has an excellent blood supply, but less efficient venous drainage when compared with posteriorly based flap. The platysma myocutaneous flap dates back to 1887 when an austrian surgeon, robert gersuny, described repair of a cheek defect. Platysma definition of platysma by the free dictionary. The superiorly based platysma myocutaneous flap is a common reconstruction option for intraoral defects followed after excision of fibrous bands in oral submucous fibrosis. Submental flap was associated with significantly higher patients. The platysma myocutaneous flap for intraoral reconstruction was introduced in 1978. Background pedicled myocutaneous flaps remain important tools in head and neck reconstruction. It is a random flap comprising skin, subcutaneous fat, superficial neck veins, and platysma muscle. Feb 21, 20 the platysma myocutaneous flap is a pedicled cervical flap initially described by the austrian surgeon gersuny7 in 1887. The plane of elevation should include the sternocleidomastoid fascia, as. Pectoralis major myocutaneous flap for head and neck defects. However, there are several reasons why this flap should remain in our armamentarium of reconstructive options. Conclusions the platysma flap is simple and versatile with properties similar to the radial forearm free flap.
This flap is an attractive reconstructive option and offers. The platysma flap was described in 1970 by paul tessier, but was immediately eclipsed by other techniques such as the myocutaneous pectoralis flap or the microsurgical temporary flap 57. Although microvascular free tissue transfer using various donor sites is an. Use of a platysma myocutaneous flap for the reimplantation of a severed ear. 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. The following potential risk factors for complications were analyzed.
Role of platysma muscle flap in depressed scars of neck. The platysma flap may be used to close defects on the lower face, buccal mucosa, and floor of mouth. Platysma myocutaneous flap pmf is a generally used technique for. The platysma is a superficial muscle that overlaps the sternocleidomastoid. Vertical platysma myocutaneous flap that sacrifices the facial artery. Neurotized free platysma flap for functional eyelid.
Five cases are presented, three men and two women, 51 and 71. The result was a good scar with scar lying in the transversely oriented neck lines. In addition, it may be beneficial to include the external jugular andor the communicating veins in the flap. Use of versatile platysma flap in oral and maxillofacial surgery. Deepithelialized laterally based platysma flap, muscle part facing the oral cavity, was used for buccal reconstruction. The aim of the study is to present our experience using vertical pmf that sacrificed the facial artery and vein for intraoral reconstruction. Platysma myocutaneous flap its current role in reconstructive.
Yet, it was only introduced to the english literature in 1978 by futrell et al, 1 and since then, it has become established as an attractive reconstructive alternative with several potential advantages. Original article, report by ear, nose and throat journal. The platysma myocutaneous flap is a reliable reconstructive method, with survival rates of 80% to 95%. Angiographic study of the platysma, abstract background. Manual crosschecking of their references yielded 3 more articles for a total of 31. May 11, 2020 platysma bands and ageing as a person ages, changes in the tone of the skin, especially in the neck, can occur. Biologic basis of deepithelialized transverse platysma flap.
The platysma muscle is a muscle the runs from the upper chest and shoulder area, up through the neck, and attaches to the skin around the mouth and the lower jawbone. The ideal method for buccal defects should provide good outcome of both function and appearance. The platysma muscle flap used for intraoral reconstruction was first described in 1978 by futrell and colleagues. The platysma myocutaneous flap for oral cavity reconstruction. The platysma myocutaneous flap is a pedicled cervical flap initially described by the austrian surgeon gersuny7 in 1887. Health, general cell research cytological research face lifts health aspects patient outcomes research flaps surgery medical research medicine, experimental mouth diseases care and treatment rhytidoplasty surgical flaps. Pdf reconstruction of oral softtissue defects following resection of oral carcinomas can be. Five male mongrel dogs were selected for this study. It has certain advantages over other local or distant pedicled flaps and has been proved to be a reliable alternative for. Extended nasolabial flap compared with the platysma myocutaneous muscle flap for re construction of intraoral defects after release of oral submucous fibrosis. In selected cases, the flap will extend to the oropharynx.
Use of a platysma myocutaneous flap for the reimplantation of a. This article is from archives of plastic surgery, volume 40. The clavicular myocutaneous island flap, with circulation provided by the platysma and superficial cervical fascia, was first performed by paul tessier in 1970, taking his motivation from the prior experience of john barron with subcutaneous island flaps. Submental versus platysma flap for the reconstruction of. The platysma myocutaneous flap was introduced for intraoral reconstruction in.
Free flaps are the first choice in case of complex, composite, and throughthrough cheek defects with exposed bone, sinuses, orbit or dura. In these relatively young people with little skin laxity, the small amount of excess skin will redrape over the improved platysma muscle, giving a nice result. Biologic basis of deepithelialized transverse platysma. Methods from 1985 to 1995, 44 patients underwent a myocutaneous platysma flap reconstruction of the oral cavity or oropharynx. All of them were reconstructed with a platysma flap after neck dissection. Platysma medical definition merriamwebster medical dictionary. The mucosal layer and the vermilion are reconstructed with a rotational flap from the cheek mucosa. Platysma muscle flap was advanced into the defect after excision of depressed scar. 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.
Myocutaneous flaps play an important role in reconstruction of fullthickness defects of the head and neck area. The platysma myocutaneous flap has been used with promising results for the reconstruction of intraoral post ablative defects. The role of the pectoralis major myocutaneous flap pmmf in head and neck reconstruction is challenged recently due to its natural drawbacks. Jul 24, 20 platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. Atlas of muscle and musculocutaneous flaps globalhelp publication. The locations where neurovascular structures entered the platysma muscles were expressed as the percentage distance sd from the sternocleidomastoid muscle mastoid insertion to manubrium origin. Pectoralis major myocutaneous flap for head and neck. Jan 30, 20 the ideal method for buccal defects should provide good outcome of both function and appearance. The majority of the flaps 8893% were taken successfully in both groups. Evaluation of their complications are necessary to judge their merits. The platysma skin flap will survive if the blood supply from at least one region is preserved. Its main limitation is also its forte ie, lack of bulk. Clinical reliability of radial forearm free flap in repair.
Vertical platysma myocutaneous flap reconstruction for t2staged oral carcinoma article pdf available in anticancer research 274c. 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. Platysma muscle cutaneous flap for large defects of the. My ps recommends a submental lipectomy with plicatio of. Platysma myocutaneous flap including the external jugular vein with special reference to neck dissection. The platysma musculocutaneous plm flap was first applied to intraoral reconstructions in 1987, and cervival island flap in 1950. Free flaps, particularly the radial forearm flap, provide excellent options for intraoral reconstruction of surgical defects.
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. The posterosuperiorly based platysmal myocutaneous flap. Pdf platysma myocutaneous flap its current role in reconstructive. Historically the use of the platysma myocutaneous flap can be traced back to. However, the platysma flap remains an alternative for reconstruction of the oral cavity because it is versatile, portable, and thin. Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection.
1317 384 730 892 546 1447 315 193 1230 1087 1364 484 358 1288 405 184 792 256 80 613 425 1195 627 266 1172 1377 1383 359 116 1274 883 1143 558 1366 1076 96 1356 125