It is a random flap comprising skin, subcutaneous fat, superficial neck veins, and platysma muscle. Jun 01, 2010 the authors conclude that the platysma myocutaneous flap provides thin, pliable, reliable tissue for use in the oral cavity. Turkey neck is more common in women than men, and many people seek cosmetic surgical procedures, such as a neck lift, to reduce the appearance of. The superior thyroid, facial, and lingual vessels were the major pedicles in 814 57.
The thinness of the flap, the color match, and the presence of functional subcutaneous muscle are unmatched by any other flap that does not originate on the face. Most authors who described the technique used a superiorly based flap. The technique described has provided an acceptable cosmetic and functional result. Role of platysma muscle flap in depressed scars of neck. In reconstruction of soft tissue defects, the fascio. When considering the complications that can occur when adopting this technique one has to include total or partial necrosis of skin island, fistula, dehiscence, hematoma, and. These patients received surgical reconstruction of platysma flap and submental flap at the department of. Upon completion of the techniques, the integrity of the cervical branches was evaluated. He also reports on the use of closed platysma myotomy to treat remaining or recurrent platsymal bands. 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. Wound infection after carotid endarterectomy is an extremely uncommon complication. Platysma medical definition merriamwebster medical dictionary. Historically the use of the platysma myocutaneous flap can be traced back.
Reconstruction of fullthickness cheek defects using. Five cases are presented, three men and two women, 51 and 71. Platysma definition and meaning collins english dictionary. The platysma myocutaneous flap operative techniques in.
To delineate the superior facial extent of the platysma muscle. Jul 24, 20 platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. Original article defining the facial extent of the platysma. First described by esser in 1918, the cervicofacial flap was first described in its modern form by juri 1and juri in 1979. The platysma skin flap will survive if the blood supply from at least one region is preserved. The platysma muscle is found at the front of the neck, under the chin. The plane of elevation should include the sternocleidomastoid fascia, as. Use of a platysma myocutaneous flap for the reimplantation of. This flap receives its blood supply primarily from branches of the a. The platysma myocutaneous flap, operative techniques in. 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. 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. The platysma myocutaneous flap has enjoyed limited popularity despite its versatility, dependability, and ease of harvesting. Historically the use of the platysma myocutaneous flap can be traced back to 1887, when robert gersuny7, a surgeon from austria described a reconstruction of a fullthickness cheek defect with a cervical skinplatysma flap which was rotated inward to provide a new lining for the buccal mucosa.
Original article defining the facial extent of the. Objectives the use, advantages, and disadvantages of the platysma flap were assessed. In cases in which the surgical defect is small and the options for free flap use are limited, the platysma myocutaneous flap is. Of all these methods, the platysma myocutaneous flap is a good candidate for oral reconstruction for several reasons. The following 4 platysmaplasty maneuvers were each performed on 4 hemifacesnecks. Platysma muscle cutaneous flap for large defects of the. Five patients who had suffered partial or total traumatic avulsion of an ear were seen at the emergency unit of the university hospital of the faculty of medicine of ribeirao preto, university of sao paulo. The overall quality of life in these patients was excellent. The platysma myocutaneous flap is an infrequently used flap in head and neck reconstruction. Research open access vertical platysma myocutaneous flap that.
Submental versus platysma flap for the reconstruction of. 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. In this article, we describe 12 consecutive patients who underwent platysma flap reconstruction of various oral cavity and oropharyngeal defects. 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. Reconstruction of hypopharyngeal and cervical esophageal. 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 platysma myocutaneous flap provides thin, pliable, reliable tissue for use in the oral cavity. Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. The flap is oriented in the mandibular cheek region.
The purpose of this study is to introduce the use of a singlestaged and laterally based platysma myocutaneous flap in patch stricturoplasty for relieving short and benign cervical esophageal stricture. The aim of the study is to present our experience using vertical pmf that. Platysma bands and ageing as a person ages, changes in the tone of the skin, especially in the neck, can occur. The mucosal layer and the vermilion are reconstructed with a rotational flap from the cheek mucosa.
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. 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. We propose here the use of a platysma myocutaneous flap for the reimplantation of a severed ear in two surgical steps. Its point of origination is the upper portions of the pectoral, or. Platysma muscle flap appears to be a good alternative method for the reconstruction of the facial defects. Vertical platysma myocutaneous flap that sacrifices the facial artery. Free flaps, particularly the radial forearm flap, provide excellent options for intraoral reconstruction of surgical defects. Use of muscle flap to cover infections of the carotid. Based on the experience acquired using the depressor anguli oris flap for lateral lower lip reconstruction, the authors in this paper present their own technique to reconstruct large deficits of the lower lateral lip, involving the commissure and the mental region, by means of a platysma muscle cutaneous flap with a triangular skin island. If an external skin defect is to be covered, the skin over the platysma muscle between the paddle and defect may be elevated to create a tunnel or skin incision between the defect and skin paddle and the skin reflected back off the platysma on either side. The superiorly based platysma myocutaneous flap is a common reconstruction option for intraoral defects followed after excision of fibrous bands in oral submucous fibrosis. Feb 21, 20 historically the use of the platysma myocutaneous flap can be traced back to 1887, when robert gersuny7, a surgeon from austria described a reconstruction of a fullthickness cheek defect with a cervical skin platysma flap which was rotated inward to provide a new lining for the buccal mucosa. Myocutaneous flaps play an important role in reconstruction of fullthickness defects of the head and neck area.
The platysma myocutaneous flap for oral cavity reconstruction kevin h. Composite platysmaplasty and closed percutaneous platysma. Use of muscle flap to cover infections of the carotid artery after carotid endarterectomy dimitrios c. Methods total 65 patients were included in this study from march 2005 to december 2012. Pdf vertical platysma myocutaneous flap reconstruction. 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.
Apr 21, 2020 platysma bands and ageing as a person ages, changes in the tone of the skin, especially in the neck, can occur. To date, the use of this flap has been hindered at least partly by uncertainty regarding contraindications and complication rates. Surgery including fibrotomy followed by reconstruction with platysma flap was planned. Platysma myocutaneous flap for oral cavity reconstruction. A vertical incision was made on the platysma, parallel to the midline, followed by the creation of a flap made of skin and platysma at the area where tone loss was more evident.
This anatomic study supports the vascular viability of the platysma flap in 2 different designs for oral and maxillofacial reconstruction. Platysma myocutaneous flap its current role in reconstructive. There are several reasons why we believe that the facial component of the platysma has been underappreciated. Open access guest editorial kummoona platysma muscle flap for. In addition, it may be beneficial to include the external jugular andor the communicating veins in the flap.
Platysma myocutaneous flap for reconstruction of intraoral. Although variability exists, platysma neurovascular pedicles enter at predictable locations between 28 57% of the distance from the mastoid insertion of the scm, therefore making free platysma transfer a feasible option for eyelid for reconstruction. This platysma flap with a fan shape, it is local transposition flap, axial pattern designed by the author for reconstruction of the atro phied and underdeveloped masseter muscle in cases of hemifacial microsomia or first arch dysplasia syndrome to improve the bulk and. Platysma myocutaneous flap for patch stricturoplasty in. Read reconstruction of hypopharyngeal and cervical esophageal defect after resection of hypopharyngeal carcinoma. Cervical flaps with and without the inclusion of the underlying platysma muscle have been described previously and used for many years. 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. Reconstruction of fullthickness cheek defects using platysma. The platysma myocutaneous flap was introduced for intraoral reconstruction in 1978.
When this flap was pulled back, it formed a double. In this study, a different application of the platysma myocutaneous flap for the reconstruction of fullthickness cheek defects is presented. It has been thought that these bands appear as the skin starts to sag due to a loss of. The arc of rotation is suitable for reconstruction of the lower lip, floor of mouth, ventral tongue, and lower one third of the face. Anatomy of the platysma muscle and the evaluation of it.
The platysma myocutaneous flap is a reliable reconstructive method, with survival rates of 80% to 95%. The use of platysma myocutaneous flap in reconstructing oral defects after carcinoma surgery has low morbidity in the form of a scar at donor site. Typically, anatomists use an outsidein approach whenstudyingmusclelayers. The purpose of this report is to examine the experience and results obtained with the use of reconstruction of intraoral defects with platysma myocutaneous flap. The aim of the study is to present our experience using vertical pmf that sacrificed the facial artery and vein for intraoral reconstruction. Use of a platysma myocutaneous flap for the reimplantation of a severed ear.
It was used in four patients operated on under local. 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. The platysma flap is a good method to reconstruct small and medium sized defects of oral cavity, especially in patients where a microsurgery reconstruction is not possible. However the limitations for use of the platysma myocutaneous flap are.
The platysma muscle is expansive in size, with a broad width that spans the collarbone, or clavicle, and the side of the neck. Platysma myocutaneous flap pmf is a generally used technique for. Original article, report by ear, nose and throat journal. Neurotized free platysma flap for functional eyelid. The platysma myocutaneous flap is very satisfactory for the repair of the posterior pharyngeal wall as it is easy to perform, it is oncologically safe and its functional results match well with other forms of reconstruction, with the advantage of laryngeal preservation. The dissection plane in the facial portion of the flap can be either in the subcutaneous or subsmas levels. Vertical platysma myocutaneous flap that sacrificed the facial artery, with the specific advantages of being easy to prepare and having few limitations, may provide an efficient method for intraoral reconstruction, and our experience in handling the flap may contribute to the success rate. Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects. Jan 26, 2015 the platysma muscle is expansive in size, with a broad width that spans the collarbone, or clavicle, and the side of the neck. It is a broad sheet arising from the fascia covering the upper parts of the pectoralis major and deltoid.
The incorporation of the smas can theoretically change the blood supply of the flap from a random to an axial pattern via perforators from the transverse facial artery. Anatomic dissections on five fresh cadavers for the evaluation of the vascular structures and 11 clinical cases of reconstruction of the defects of the face and the neck with platysma muscle. Its main limitation is also its forte ie, lack of bulk. The method of flap elevation will vary depending on the indication for flap use. Currently, the most commonly used reconstruction technique is microvascular free flaps. Twenty patients were treated for intraoral epidermoid carcinoma with a singlestage reconstructive technique using a myocutaneous flap based. Use of a platysma myocutaneous flap for the reimplantation. This was probably the first description of the platysma myocutaneous flap used for head and neck reconstruction. Open access guest editorial kummoona platysma muscle. The superiorly based flap has an excellent blood supply, but less efficient venous drainage when compared with posteriorly based flap. The platysma flap can be used reliably even when an ipsilateral neck. Use of the innervated platysma flap in facial reanimation. There was one distal flap necrosis and one wound dehiscence of the neck. Platysma myocutaneous flap for intraoral reconstruction.
Use of versatile platysma flap in oral and maxillofacial surgery. The results of treatment of 36 patients tumour excision plus bilateral neck dissection and post. All surgical procedures involving use of a platysma flap for reconstruction of an. Platysma medical definition merriamwebster medical. The innervated platysma musculocutaneous flap replaces facial tissue with like tissue. Vertical platysma myocutaneous flap that sacrifices the. The platysma myocutaneous flap oral and maxillofacial surgery. Platysma is also a plant taxon synonym with podochilus, an orchid genus. 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. The additional operating room time is negligible, the surgical complications minimal, and the overall quality of life very good. Research open access vertical platysma myocutaneous. The platysma myocutaneous flap for oral cavity reconstruction. The platysma is a superficial muscle that overlaps the sternocleidomastoid.
336 28 207 1538 511 1258 1569 1298 8 1538 961 166 366 185 1546 1016 1253 1588 845 844 561 137 1020 733 1116 1190 1435 358 403 1264 395 636 1075 610 50 631 1087