Our experience in handling the flap may contribute to the success rate. The superiorly based platysma myocutaneous flap is a common reconstruction option for intraoral defects followed after excision of fibrous bands. Two 30 polypropylene suspension sutures were used to elevate the cheek. Mylohyoid advancement flap for closure of composite oral. The submental flap is gaining popularity as a simple technique for reconstruction of. Pdf vertical platysma myocutaneous flap reconstruction. Jflap finalist candidate in needs premier award 2007 announced oct, 12, 2007 at fie 2007, jflap 6. Zenn c, bien keem tan d, chyilong lee e a division of reconstructive microsurgery, department of plastic and reconstructive surgery, chang gung memorial hospital. However, there seems to be a role for regional or local flaps. In short, a platysmaplasty is a surgical procedure that addresses the cords or bands located on the front of the neck. 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. Use of versatile platysma flap in oral and maxillofacial surgery. Pdf platysma myocutaneous flap its current role in reconstructive. Pdf platysma myocutaneous flap for reconstruction of intraoral.
The flap adds protection and security and allows you to take your files wherever you go. 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. The platysma myocutaneous flap pmf was first used for intraoral. Dissection of the flap along with the platysma in this plane will ensure that the vascularity of the flap is not compromised. Role of platysma muscle flap in depressed scars of neck. In 1951, edgerton described a lateral cervical island flap based on the platysma muscle for reconstruction of intraoral defects. 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. Head and neck reconstruction with the infrahyoid flap in. Research open access vertical platysma myocutaneous flap. Surgical management of oral submucous fibrosis osmf. 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. The outline of the platysma flap is initially made as an. 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.
The sensing lead, which is placed between the internal and intercostal muscles to monitor respirations, is also connected to the pulse generator. Codes that require prior approval for blue medicare hmo andor blue medicare ppo july 2018 page 1 special notes. We have added a list of all the downloadable media here on this page. July 29, 2016 jflap modules and exercises are a comprehensive list of descriptions of jflap topics with examples, followed by exercises. 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. Reconstruction of fullthickness cheek defects using platysma. Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an. Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects. 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 diverse indications described for the platysma myocutaneous. Free flaps, particularly the radial forearm flap, provide excellent options for intraoral reconstruction of surgical defects. 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. Available in a variety of sizes, pockets, materials, expansions, and with preprinted and customizable tabs. The platysma myocutaneous flap dates back to 1887 when an austrian surgeon, robert gersuny, described repair of a cheek defect. Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects andre m. Available in a variety of sizes, pockets, closures, materials, expansions, and with preprinted and customizable tabs. Reconstruction of fullthickness cheek defects using.
Department of craniomaxillofacial surgery, faculty of dentistry, hannover medical university, hannover, germany. Manual crosschecking of their references yielded 3 more articles for a total of 31. The platysma myocutaneous flap has seen limited application in the reconstruction of head and neck defects over the past decade. 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.
Large area of the skin from the inferior part of the neck can be harvested for defects of the cheek. The platysma myocutaneous flap, operative techniques in. A metaanalysis of the randomized controlled trials, in plos. Role of platysma muscle flap in depressed scars of neck rakesh k. Cervicopectoral flap in head and neck cancer surgery. 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. 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 aim of the study is to present our experience using vertical pmf that sacrificed the facial artery and vein for intraoral reconstruction.
The flap design and the size depended on the anticipated defect. In selected cases, the flap will extend to the oropharynx. The first recorded crosslip flap was performed by pietro sabattini of innola, italy. Platysma myocutaneous flap revisited jama otolaryngology. There are anatomical and physiological reasons for this. 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. Vertical platysma myocutaneous flap reconstruction for t2staged oral carcinoma article pdf available in anticancer research 274c.
Surgical technique the split orbicularis myomucosal flap. Platysma myocutaneous flap its current role in reconstructive. Use of a platysma myocutaneous flap for the reimplantation. 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. Rakesh kumar sandhir, a402, sector 31, noida 201 303, india. 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. Unlisted or miscellaneous cpthcpcs codes should only be used if a more specific code. 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. 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 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.
Pedicled flap in lingual cancer reconstruction 14377 int j clin exp med 2016. 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. 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 platysmal myocutaneous flap has shown promising results for the reconstruction of defects in the head and neck region. Cervicopectoral flap is a one such flap from chest and neck skin mainly used to cover. Use of a platysma myocutaneous flap for the reimplantation of. Atlas of muscle and musculocutaneous flaps globalhelp publication. It is a broad sheet arising from the fascia covering the upper parts of the pectoralis major and deltoid. The platysma flap was first used by gersuny 1887 for reconstruction of a throughandthrough cheek defect. The posteriorly based platysma flap in oral and facial reconstruction. Desprez and kiehn 1959 reported the modified apron flap. Platysma myocutaneous flap for oral cavity reconstruction. The mean reduction in mouth opening was significantly smaller in platysma group 0.
Below are the links to the authors original submitted files for images. The posterosuperiorly based platysmal myocutaneous flap. All of them were reconstructed with a platysma flap after neck dissection. Five cases are presented, three men and two women, 51 and 71. Hence, a thorough knowledge of nerve anatomy, particularly its potential variations, is critical in reducing the associated operative morbidity. Platysma myocutaneous flap for patch stricturoplasty in. 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. Please refer to the blue medicare hmoppo medical coverage policies for. Platysma myocutaneous flap pmf is a generally used technique for defect. It is great to have a reference that is quick to access.
Platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection. Muscles of the face, head and neck flashcards quizlet. It was used in four patients operated on under local. Original article, report by ear, nose and throat journal. Platysma muscle additionally innervated by a variant. The platysma myocutaneous flap for oral cavity reconstruction kevin h. Latysm anatomical considerations surface markings adjacent muscles vascular pattern motor nerve. The plane of elevation should include the sternocleidomastoid fascia, as. Defects caused by the resection should be closed with flaps which match in color, texture and hair bearing characteristics with the face. In this study, a different application of the platysma myocutaneous flap for the reconstruction of fullthickness cheek defects is presented. The skin territory of the single pedicle submental island flap is as large as 7. Myocutaneous flaps play an important role in reconstruction of fullthickness defects of the head and neck area.
Great for organizing any project these smead expanding files allow desktop, work surface or countertop organization with easy access. Desprez and kiehn 1959 reported the modified apron flap, which included the platysma muscle. Platysma myocutaneous flap for intraoral reconstruction, am. 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.
The platysma myocutaneous flap for oral cavity reconstruction. 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. The platysma myocutaneous flap for intraoral reconstruction was introduced in 1978. 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. Vertical platysma myocutaneous flap that sacrifices the facial artery. Submental versus platysma flap for the reconstruction of. Original article the submental island flap in lingual cancer. Reconstruction of the head and neck after adequate resection of primary tumor and neck dissection is a challenge. Mylohyoid advancement flap for closure of composite oral cavity defects. 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.
In cases in which the surgical defect is small and the options for free flap use are limited, the platysma myocutaneous flap is. This study evaluated the blood supply of the superiorly based and posteriorly based platysma muscle myocutaneous flap. Pdf utility of superiorly based platysma myocutaneous. Traditional facelifts do just what their name states. Research open access the submental flap for oral cavity reconstruction. Original article the submental island flap in lingual. 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. Psp facelift beverly hills platysma smas plication santa. The skin flap u shaped is elevated in the subplatysmal plane. Pdf vertical platysma myocutaneous flap reconstruction for. The goals of facial reconstruction center on closing defects in an inconspicuous manner. Sophus august vilhelm stein of copenhagen, denmark, described bilateral upper central lip flaps for reconstruction of a lower lip defect 10. The skin of the neck receives its blood supply from the perforators of platysma muscle.
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. Surgical technique the split orbicularis myomucosal flap for. Before flap harvesting the anticipated intraoral defect is measured. 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. Angiographic study of the platysma, abstract background. A novel approach to the treatment of lower extremity. The platysma myocutaneous flap was introduced for intraoral reconstruction. Sophus august vilhelm stein of copenhagen, denmark, described bilateral upper cen. Fortunately, the robust vascular supply of the face allows. The platysmal myocutaneous flap has shown promising results for the.
This flap receives its blood supply primarily from branches of the a. You can also choose from elastic closure folder, presentation folder, and clip file flap file, as well as from pp, paper, and leather flap file there are 1,012 suppliers who sells flap file on, mainly located in asia. A wide variety of flap file options are available to you, such as folder, bag, and wallet. The outline of the platysma flap is initially made as an ellipse with the inferior margin low in the neck above the clavicle. The flap is drained through submental vein into the facial vein. 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. Twentynine patients received composite resection, marginal mandibulectomy, and reconstruction with the mylohyoid muscle flap between 1999 and 2008. Keep your desk, work surface or countertop organized with a smead expanding file. Atlas of muscle and musculocutaneous flaps platysma. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Is it possible platysmaplasty can be done without any incision under the chin. We propose here the use of a platysma myocutaneous flap for the reimplantation of a severed ear in two surgical steps. Pdf platysma myocutaneous flap its current role in. An external file that holds a picture, illustration, etc.
It should be performed at one sitting in advanced tumors. The technique described has provided an acceptable cosmetic and functional result. Head and neck reconstruction with the infrahyoid flap in era. Malleswara rao professors of neurosurgery, department of neurosurgery, narayna medical college hospital, chinthareddypalem, nellore, andhra pradesh india abstract anterior surgical approaches provide. The platysma flap may be used to close defects on the lower face, buccal mucosa, and floor of mouth. 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. This reconstruction technique was chosen because of the poor. 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. Transverse cervical skin incision and vertical platysma splitting approach for anterior cervical vertebral column exposure amit agrawal, g.
Vertical platysma myocutaneous flap that sacrifices the. 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. The arc of rotation is suitable for reconstruction of the lower lip, floor of mouth, ventral tongue, and lower one third of the face. Transverse cervical skin incision and vertical platysma. The platysma myocutaneous flap was introduced for intraoral reconstruction in 1978. Dec 01, 2005 reconstruction of the primary defect is an integral part of the surgical treatment of head and neck cancer.