Arch Plast Surg.  2012 Nov;39(6):626-630. 10.5999/aps.2012.39.6.626.

Reconstruction of the Head and Neck Region Using Lower Trapezius Musculocutaneous Flaps

• Yoon SK
• Song SH
• Kang N
• Yoon YH
• Koo BS
• Oh SH

• KMID: 2120713
• DOI: http://doi.org/10.5999/aps.2012.39.6.626

Abstract

BACKGROUND
Recent literature has indicated that free flaps are currently considered the preferred choice for head and neck reconstruction. However, head and neck cancer patients are frequently treated with chemoradiotherapy, which is often associated with a poor general and local condition, and thus, such patients are ineligible for free flap reconstruction. Therefore, other reconstruction modalities should be considered.
METHODS
We used lower trapezius musculocutaneous (LTMC) flap based on the dorsal scapular artery to reconstruct head and neck defects that arose from head and neck cancer in 8 patients. All of the patients had undergone preoperative chemoradiotherapy.
RESULTS
There were no complications except one case of partial flap necrosis; it was treated with secondary intention. Healing in the remaining patients was uneventful without hematoma, seroma, or infection. The donor sites were closed primarily.
CONCLUSIONS
The LTMC flap is the preferred flap for a simple, reliable, large flap with a wide arc of rotation and minor donor-site morbidity. The authors recommend this versatile island flap as an alternative to microvascular free tissue transfer for the reconstruction of defects in the head and neck region, for patients that have undergone preoperative chemoradiotherapy.

Keyword

Head and neck neoplasms; Reconstructive surgical procedures; Chemoradiotherapy; Surgical flaps

MeSH Terms

Arteries
Chemoradiotherapy
Free Tissue Flaps
Head
Head and Neck Neoplasms
Hematoma
Humans
Intention
Neck
Reconstructive Surgical Procedures
Seroma
Surgical Flaps
Tissue Donors