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. Feb 21, 20 the outline of the platysma flap is initially made as an ellipse with the inferior margin low in the neck above the clavicle. Rakesh kumar sandhir, a402, sector 31, noida 201 303, india. Original article, report by ear, nose and throat journal. 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. Twentynine patients received composite resection, marginal mandibulectomy, and reconstruction with the mylohyoid muscle flap between 1999 and 2008. Pdf platysma myocutaneous flap its current role in reconstructive. 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. Extended indications and technical refinements ayman a amin1, mostafa a sakkary1, ashraf a khalil2, mohammmed a rifaat1 and sherif b zayed1 abstract background and purpose. Original article the submental island flap in lingual cancer. Reconstruction of fullthickness cheek defects using.
Reconstruction of fullthickness cheek defects using platysma. Pedicled flap in lingual cancer reconstruction 14377 int j clin exp med 2016. There are anatomical and physiological reasons for this. It should be performed at one sitting in advanced tumors. Platysma myocutaneous flap pmf is a generally used technique for defect. Defects caused by the resection should be closed with flaps which match in color, texture and hair bearing characteristics with the face. The platysma myocutaneous flap for oral cavity reconstruction. Platysma myocutaneous flap its current role in reconstructive. 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. Latysm anatomical considerations surface markings adjacent muscles vascular pattern motor nerve. Head and neck reconstruction with the infrahyoid flap in. Five cases are presented, three men and two women, 51 and 71. Available in a variety of sizes, pockets, materials, expansions, and with preprinted and customizable tabs. 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.
Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects andre m. Surgical technique the split orbicularis myomucosal flap. Cervicopectoral flap is a one such flap from chest and neck skin mainly used to cover. There has been an emphasis on the anatomical vascular supply and method of preparation of the platysma myocutaneous flap and its use in the oral cavity. The platysmal myocutaneous flap has shown promising results for the reconstruction of defects in the head and neck region. Platysma muscle additionally innervated by a variant. The posteriorly based platysma flap in oral and facial reconstruction. Available in a variety of sizes, pockets, closures, materials, expansions, and with preprinted and customizable tabs. 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. 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 vertical platysma myocutaneous flap reconstruction. Psp facelift beverly hills platysma smas plication santa. The platysma myocutaneous flap dates back to 1887 when an austrian surgeon, robert gersuny, described repair of a cheek defect. Our experience in handling the flap may contribute to the success rate. The platysma flap was first used by gersuny 1887 for reconstruction of a throughandthrough cheek defect. Vertical platysma myocutaneous flap that sacrifices the facial artery. Great for organizing any project these smead expanding files allow desktop, work surface or countertop organization with easy access.
Platysma flap for reconstruction in oral submucous fibrosis osmf fibrotomy dpne at the occlusal level from corner of mouth to retromolar region bilateral coronidectomy done mouth openig of. Below are the links to the authors original submitted files for images. However, there seems to be a role for regional or local flaps. The plane of elevation should include the sternocleidomastoid fascia, as.
Platysma myocutaneous flap for patch stricturoplasty in. Traditional facelifts do just what their name states. Research open access vertical platysma myocutaneous flap. This flap receives its blood supply primarily from branches of the a. Pdf utility of superiorly based platysma myocutaneous. The platysma myocutaneous flap was introduced for intraoral reconstruction. Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an. The aim of the study is to present our experience using vertical pmf that sacrificed the facial artery and vein for intraoral reconstruction. The flap is drained through submental vein into the facial vein.
In 1951, edgerton described a lateral cervical island flap based on the platysma muscle for reconstruction of intraoral defects. Sophus august vilhelm stein of copenhagen, denmark, described bilateral upper cen. Flap design in facial reconstruction is particularly delicate given the face is the most visible structure of the body and has some of the most complex threedimensional topography. The mean reduction in mouth opening was significantly smaller in platysma group 0. The platysma myocutaneous flap for intraoral reconstruction was introduced in 1978. Research open access the submental flap for oral cavity reconstruction.
Use of a platysma myocutaneous flap for the reimplantation of. The flap design and the size depended on the anticipated defect. A periodontal flap is a section of gingiva andor mucosa surgically separated from the underlying tissues to provide visibility and access to the bone and root surface. It is great to have a reference that is quick to access. Head and neck reconstruction with the infrahyoid flap in era. The platysma flap may be used to close defects on the lower face, buccal mucosa, and floor of mouth. Clinical significance edit in a similar fashion to other muscles, the platysma is vulnerable to tears, strains and muscle atrophy among many other possible conditions. 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 myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects. The goals of facial reconstruction center on closing defects in an inconspicuous manner. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
Damage to the great auricular nerve, with consequent clinical deficits, is a common surgical complication in facial aesthetic and in head and neck procedures such as parotidectomy, neck dissection, rhytidectomy and platysma flap operations. If a standard aprontype flap is raised for a neck dissection, the inferior margin of that flap will be the inferior margin of the platysma flap. Hence, a thorough knowledge of nerve anatomy, particularly its potential variations, is critical in reducing the associated operative morbidity. The flap adds protection and security and allows you to take your files wherever you go. Before flap harvesting the anticipated intraoral defect is measured. The platysma myocutaneous flap was introduced for intraoral reconstruction in 1978.
Muscles of the face, head and neck flashcards quizlet. Large area of the skin from the inferior part of the neck can be harvested for defects of the cheek. Mylohyoid advancement flap for closure of composite oral. 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. The arc of rotation is suitable for reconstruction of the lower lip, floor of mouth, ventral tongue, and lower one third of the face.
Dec 01, 2005 reconstruction of the primary defect is an integral part of the surgical treatment of head and neck cancer. Keep your desk, work surface or countertop organized with a smead expanding file. Role of platysma muscle flap in depressed scars of neck. Myocutaneous flaps play an important role in reconstruction of fullthickness defects of the head and neck area. This reconstruction technique was chosen because of the poor. Desprez and kiehn 1959 reported the modified apron flap. Unlisted or miscellaneous cpthcpcs codes should only be used if a more specific code. Jflap finalist candidate in needs premier award 2007 announced oct, 12, 2007 at fie 2007, jflap 6.
Two 30 polypropylene suspension sutures were used to elevate the cheek. Vertical platysma myocutaneous flap that sacrifices the. Platysma myocutaneous flap for intraoral reconstruction, am. Reconstruction of the head and neck after adequate resection of primary tumor and neck dissection is a challenge. Atlas of muscle and musculocutaneous flaps platysma. In this study, a different application of the platysma myocutaneous flap for the reconstruction of fullthickness cheek defects is presented. Atlas of muscle and musculocutaneous flaps globalhelp publication.
The skin of the neck receives its blood supply from the perforators of platysma muscle. Use of versatile platysma flap in oral and maxillofacial surgery. Dissection of the flap along with the platysma in this plane will ensure that the vascularity of the flap is not compromised. However, the platysma plays only a minor role in depressing the lip which is primarily performed by the depressor anguli oris and the depressor labii inferioris. Fortunately, the robust vascular supply of the face allows. Pdf vertical platysma myocutaneous flap reconstruction for. Sophus august vilhelm stein of copenhagen, denmark, described bilateral upper central lip flaps for reconstruction of a lower lip defect 10. Free flaps, particularly the radial forearm flap, provide excellent options for intraoral reconstruction of surgical defects. Original article the submental island flap in lingual. Please refer to the blue medicare hmoppo medical coverage policies for. The procedure will require a camouflaged incision below the chin which provides the surgeon access to the edges of the platysma muscle or the bands. The skin flap u shaped is elevated in the subplatysmal plane. Role of platysma muscle flap in depressed scars of neck rakesh k.
This study evaluated the blood supply of the superiorly based and posteriorly based platysma muscle myocutaneous flap. The outline of the platysma flap is initially made as an ellipse with the inferior margin low in the neck above the clavicle. The submental flap is gaining popularity as a simple technique for reconstruction of. In cases in which the surgical defect is small and the options for free flap use are limited, the platysma myocutaneous flap is. Mylohyoid advancement flap for closure of composite oral cavity defects. It is a broad sheet arising from the fascia covering the upper parts of the pectoralis major and deltoid. In short, a platysmaplasty is a surgical procedure that addresses the cords or bands located on the front of the neck.
Pdf platysma myocutaneous flap its current role in. The outline of the platysma flap is initially made as an. It was used in four patients operated on under local. The sensing lead, which is placed between the internal and intercostal muscles to monitor respirations, is also connected to the pulse generator. Angiographic study of the platysma, abstract background.
Desprez and kiehn 1959 reported the modified apron flap, which included the platysma muscle. Malleswara rao professors of neurosurgery, department of neurosurgery, narayna medical college hospital, chinthareddypalem, nellore, andhra pradesh india abstract anterior surgical approaches provide. July 29, 2016 jflap modules and exercises are a comprehensive list of descriptions of jflap topics with examples, followed by exercises. Surgical management of oral submucous fibrosis osmf.
The platysma myocutaneous flap pmf was first used for intraoral. 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. Cervicopectoral flap in head and neck cancer surgery. Vertical platysma myocutaneous flap reconstruction for t2staged oral carcinoma article pdf available in anticancer research 274c. Is it possible platysmaplasty can be done without any incision under the chin. Submental versus platysma flap for the reconstruction of. In selected cases, the flap will extend to the oropharynx.
We have added a list of all the downloadable media here on this page. Transverse cervical skin incision and vertical platysma. Since the first report of a platysma transverse myocutaneous flap in 1977, few articles about this flap design have been added to the literature. The diverse indications described for the platysma myocutaneous. Chapter 4 infrahyoid fasciomyocutaneous flap as an alternative to free radial 33 forearm flap in head and neck reconstruction deganello a, manciocco v, dolivet g, leemans cr, spriano g. Zenn c, bien keem tan d, chyilong lee e a division of reconstructive microsurgery, department of plastic and reconstructive surgery, chang gung memorial hospital.
Surgical technique the split orbicularis myomucosal flap for. 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. If the platysma needed more tightening, the lateral edge would be undermined and attached with a lateral vector to the periosteum of the mastoid process. The platysma myocutaneous flap, operative techniques in.
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 zhou, md thoracic surgery department, daping hospital, third military medical university, chongqing city, china. Platysma myocutaneous flap for oral cavity reconstruction. Platysma myocutaneous flap revisited jama otolaryngology. Codes that require prior approval for blue medicare hmo andor blue medicare ppo july 2018 page 1 special notes. The platysmal myocutaneous flap has shown promising results for the. A novel approach to the treatment of lower extremity. 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. Manual crosschecking of their references yielded 3 more articles for a total of 31. Use of a platysma myocutaneous flap for the reimplantation. Four fresh cadaver specimens were injected with microfil flow technologies, inc, carver, me red stain in the common carotid artery and blue stain in the brachiocephalic vein. A metaanalysis of the randomized controlled trials, in plos. The platysma myocutaneous flap for oral cavity reconstruction kevin h.
The technique described has provided an acceptable cosmetic and functional result. An external file that holds a picture, illustration, etc. A wide variety of flap file options are available to you, such as folder, bag, and wallet. This study demonstrates that both platysma and submental flap techniques can be used for the reconstruction of complex facial defects with the acceptable functional outcome. This is a new version of jflap that was redesigned and has been under development since 2011. Small to mediumsize defects can be functionally reconstructed with the platysma myocutaneous flap as an excellent choice particularly in medically compromised patients not being eligible for free tissue transfer. The superiorly based platysma myocutaneous flap is a common reconstruction option for intraoral defects followed after excision of fibrous bands. The posterosuperiorly based platysmal myocutaneous flap. The first recorded crosslip flap was performed by pietro sabattini of innola, italy. All of them were reconstructed with a platysma flap after neck dissection. The platysma myocutaneous flap has seen limited application in the reconstruction of head and neck defects over the past decade.
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