The superior pedicled platysma-myocutaneous flap

Background: The platysma-myocutaneous flap is a surgical procedure little used in oral and oropharyngeal reconstruction after malignant tumor resection. However, it provides a fast solution of reconstruction in specific indications, with functional and esthetic results comparable to other methods.

Methods: The platysma covers the anterolateral area of the neck and constitutes a part of the superficial musculoaponevrotic system of the head and neck. The arterial vascularization relies on the external carotid network and venous drainage on the external and anterior jugular veins. Methods: The dissection of the myocutaneous-platysma flap is performed by a strict upward subplatysmal dissection. A strict subcutaneous dissection is then performed by an incision of the superior edge of the cutaneous paddle. Respecting the dissection planes as well as preservation of the facial artery, submental branch and external jugular vein improve chances of success. INDICATIONS AND CONTRA-INDICATIONS: The platysma-myocutaneous flap may help to fill defects of the oral cavity and oropharynx. The main contra-indications are prior cervical surgery and cervical radiotherapy, the presence of adenopathy requiring removal of the facial pedicle and submandibular tumor extension.