In reconstruction of soft tissue defects, the fascio. Reconstruction of hypopharyngeal and cervical esophageal. Original article defining the facial extent of the platysma. 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.
The platysma skin flap will survive if the blood supply from at least one region is preserved. Pdf vertical platysma myocutaneous flap reconstruction. Myocutaneous flaps play an important role in reconstruction of fullthickness defects of the head and neck area. Its point of origination is the upper portions of the pectoral, or. He also reports on the use of closed platysma myotomy to treat remaining or recurrent platsymal bands. It was used in four patients operated on under local. The flap is oriented in the mandibular cheek region. Platysma myocutaneous flap for intraoral 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. 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. Platysma bands and ageing as a person ages, changes in the tone of the skin, especially in the neck, can occur. There was one distal flap necrosis and one wound dehiscence of the neck. This flap receives its blood supply primarily from branches of the a. Platysma myocutaneous flap for reconstruction of intraoral. The platysma myocutaneous flap is a reliable reconstructive method, with survival rates of 80% to 95%. 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. The mucosal layer and the vermilion are reconstructed with a rotational flap from the cheek mucosa. 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. Currently, the most commonly used reconstruction technique is microvascular free flaps.
Read reconstruction of hypopharyngeal and cervical esophageal defect after resection of hypopharyngeal carcinoma. Anatomy of the platysma muscle and the evaluation of it. The innervated platysma musculocutaneous flap replaces facial tissue with like tissue. Platysma myocutaneous flap for oral cavity reconstruction. When this flap was pulled back, it formed a double. The platysma myocutaneous flap for oral cavity reconstruction kevin h. The platysma muscle is expansive in size, with a broad width that spans the collarbone, or clavicle, and the side of the neck. Platysma muscle flap appears to be a good alternative method for the reconstruction of the facial defects. Upon completion of the techniques, the integrity of the cervical branches was evaluated.
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. The aim of the study is to present our experience using vertical pmf that sacrificed the facial artery and vein for intraoral reconstruction. 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. Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. The platysma myocutaneous flap is an infrequently used flap in head and neck reconstruction. Submental versus platysma flap for the reconstruction of. 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. Platysma muscle cutaneous flap for large defects of the. All surgical procedures involving use of a platysma flap for reconstruction of an. Open access guest editorial kummoona platysma muscle flap for. The additional operating room time is negligible, the surgical complications minimal, and the overall quality of life very good. Platysma definition and meaning collins english dictionary. 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 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. Historically the use of the platysma myocutaneous flap can be traced back. The platysma myocutaneous flap provides thin, pliable, reliable tissue for use in the oral cavity. Use of a platysma myocutaneous flap for the reimplantation.
Vertical platysma myocutaneous flap that sacrifices the facial artery. It is an important consideration in scar revision surgery. 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. 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.
Cervical flaps with and without the inclusion of the underlying platysma muscle have been described previously and used for many years. Use of a platysma myocutaneous flap for the reimplantation of a severed ear. Free flaps, particularly the radial forearm flap, provide excellent options for intraoral reconstruction of surgical defects. The platysma flap can be used reliably even when an ipsilateral neck. 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. Reconstruction of fullthickness cheek defects using. 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. The platysma muscle is found at the front of the neck, under the chin. Use of muscle flap to cover infections of the carotid. However the limitations for use of the platysma myocutaneous flap are. 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.
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. In this article, we describe 12 consecutive patients who underwent platysma flap reconstruction of various oral cavity and oropharyngeal defects. Typically, anatomists use an outsidein approach whenstudyingmusclelayers. 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. This anatomic study supports the vascular viability of the platysma flap in 2 different designs for oral and maxillofacial reconstruction. Use of versatile platysma flap in oral and maxillofacial surgery. Open access guest editorial kummoona platysma muscle.
The dissection plane in the facial portion of the flap can be either in the subcutaneous or subsmas levels. Use of muscle flap to cover infections of the carotid artery after carotid endarterectomy dimitrios c. Vertical platysma myocutaneous flap that sacrifices the. Research open access vertical platysma myocutaneous flap that. The platysma myocutaneous flap was introduced for intraoral reconstruction in 1978. It is a random flap comprising skin, subcutaneous fat, superficial neck veins, and platysma muscle. In addition, it may be beneficial to include the external jugular andor the communicating veins in the flap.
The plane of elevation should include the sternocleidomastoid fascia, as. Wound infection after carotid endarterectomy is an extremely uncommon complication. Of all these methods, the platysma myocutaneous flap is a good candidate for oral reconstruction for several reasons. Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects. The following 4 platysmaplasty maneuvers were each performed on 4 hemifacesnecks. 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. The technique described has provided an acceptable cosmetic and functional result.
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. Twenty patients were treated for intraoral epidermoid carcinoma with a singlestage reconstructive technique using a myocutaneous flap based. Methods total 65 patients were included in this study from march 2005 to december 2012. This was probably the first description of the platysma myocutaneous flap used for head and neck reconstruction. 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. To delineate the superior facial extent of the platysma muscle. We propose here the use of a platysma myocutaneous flap for the reimplantation of a severed ear in two surgical steps. There are several reasons why we believe that the facial component of the platysma has been underappreciated. Platysma medical definition merriamwebster medical. The platysma myocutaneous flap oral and maxillofacial surgery. Jul 24, 20 platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. First described by esser in 1918, the cervicofacial flap was first described in its modern form by juri 1and juri in 1979. The aim of the study is to present our experience using vertical pmf that.
The superiorly based platysma myocutaneous flap is a common reconstruction option for intraoral defects followed after excision of fibrous bands in oral submucous fibrosis. The superior thyroid, facial, and lingual vessels were the major pedicles in 814 57. 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. The superiorly based flap has an excellent blood supply, but less efficient venous drainage when compared with posteriorly based flap. The platysma myocutaneous flap has enjoyed limited popularity despite its versatility, dependability, and ease of harvesting. Original article defining the facial extent of the. These patients received surgical reconstruction of platysma flap and submental flap at the department of. Role of platysma muscle flap in depressed scars of neck. Platysma is also a plant taxon synonym with podochilus, an orchid genus. However, the platysma flap remains an alternative for reconstruction of the oral cavity because it is versatile, portable, and thin.
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. Original article, report by ear, nose and throat journal. Neurotized free platysma flap for functional eyelid. 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. In cases in which the surgical defect is small and the options for free flap use are limited, the platysma myocutaneous flap is. 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. It has been thought that these bands appear as the skin starts to sag due to a loss of. Its main limitation is also its forte ie, lack of bulk. 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. 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. Objectives the use, advantages, and disadvantages of the platysma flap were assessed. The arc of rotation is suitable for reconstruction of the lower lip, floor of mouth, ventral tongue, and lower one third of the face. In this study, a different application of the platysma myocutaneous flap for the reconstruction of fullthickness cheek defects is presented. The platysma myocutaneous flap, operative techniques in.
Use of a platysma myocutaneous flap for the reimplantation of. The overall quality of life in these patients was excellent. Research open access vertical platysma myocutaneous. 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. 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. 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. The platysma myocutaneous flap operative techniques in. Reconstruction of fullthickness cheek defects using platysma. To date, the use of this flap has been hindered at least partly by uncertainty regarding contraindications and complication rates. Most authors who described the technique used a superiorly based flap. Platysma myocutaneous flap its current role in reconstructive. The method of flap elevation will vary depending on the indication for flap use.
The platysma is a superficial muscle that overlaps the sternocleidomastoid. 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. 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. Five cases are presented, three men and two women, 51 and 71.
Platysma myocutaneous flap for patch stricturoplasty in. It is a broad sheet arising from the fascia covering the upper parts of the pectoralis major and deltoid. Platysma medical definition merriamwebster medical dictionary. Composite platysmaplasty and closed percutaneous platysma. Apr 21, 2020 platysma bands and ageing as a person ages, changes in the tone of the skin, especially in the neck, can occur. Surgery including fibrotomy followed by reconstruction with platysma flap was planned. Use of the innervated platysma flap in facial reanimation. Jun 01, 2010 the authors conclude that the platysma myocutaneous flap provides thin, pliable, reliable tissue for use in the oral cavity. The results of treatment of 36 patients tumour excision plus bilateral neck dissection and post.
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