Archives of Plastic Surgery

  • 제39권6호
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  • Pages.626-630
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  • 2012
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  • 2234-6163(pISSN)
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  • 2234-6171(eISSN)
대한성형외과학회 (Korean Society of Plastic and Reconstructive Surgeons)
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Reconstruction of the Head and Neck Region Using Lower Trapezius Musculocutaneous Flaps

  • Yoon, Soo Kwang (Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine) ;
  • Song, Seung Han (Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine) ;
  • Kang, Nakheon (Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine) ;
  • Yoon, Yeo-Hoon (Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine) ;
  • Koo, Bon Seok (Department of Otorhinolaryngology-Head and Neck Surgery, Chungnam National University College of Medicine) ;
  • Oh, Sang-Ha (Department of Plastic and Reconstructive Surgery, Chungnam National University College of Medicine)
  • 투고 : 2012.06.30
  • 심사 : 2012.09.17
  • 발행 : 2012.11.15
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초록

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.

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과제정보

연구 과제 주관 기관 : Chungnam National University

참고문헌

  1. Choi EC, Kim CH, Kim SH, et al. The role of pectoralis major myocutaneous flap in the era of free flap. Korean J Head Neck Oncol 2001;17:190-3.
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  3. Pallua N, Magnus Noah E. The tunneled supraclavicular island flap: an optimized technique for head and neck reconstruction. Plast Reconstr Surg 2000;105:842-51. https://doi.org/10.1097/00006534-200003000-00003
  4. Netterville JL, Wood DE. The lower trapezius flap. Vascular anatomy and surgical technique. Arch Otolaryngol Head Neck Surg 1991;117:73-6. https://doi.org/10.1001/archotol.1991.01870130079020
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  6. Mathes SJ, Nahai F. Clinical atlas of muscle and musculocutaneous flap. St. Louis: Mosby; 1979.
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  9. Urken ML, Naidu RK, Lawson W, et al. The lower trapezius island musculocutaneous flap revisited. Report of 45 cases and a unifying concept of the vascular supply. Arch Otolaryngol Head Neck Surg 1991;117:502-11. https://doi.org/10.1001/archotol.1991.01870170048012
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  11. Haas F, Weiglein A, Schwarzl F, et al. The lower trapezius musculocutaneous flap from pedicled to free flap: anatomical basis and clinical applications based on the dorsal scapular artery. Plast Reconstr Surg 2004;113:1580-90. https://doi.org/10.1097/01.PRS.0000117188.03152.10
  12. Lynch JR, Hansen JE, Chaffoo R, et al. The lower trapezius musculocutaneous flap revisited: versatile coverage for complicated wounds to the posterior cervical and occipital regions based on the deep branch of the transverse cervical artery. Plast Reconstr Surg 2002;109:444-50. https://doi.org/10.1097/00006534-200202000-00005
  13. Angrigiani C, Grilli D, Karanas YL, et al. The dorsal scapular island flap: an alternative for head, neck, and chest reconstruction. Plast Reconstr Surg 2003;111:67-78. https://doi.org/10.1097/00006534-200301000-00010
  14. Tan KC, Tan BK. Extended lower trapezius island myocutaneous flap: a fasciomyocutaneous flap based on the dorsal scapular artery. Plast Reconstr Surg 2000;105:1758-63. https://doi.org/10.1097/00006534-200004050-00025
  15. Ugurlu K, Ozcelik D, Huthut I, et al. Extended vertical trapezius myocutaneous flap in head and neck reconstruction as a salvage procedure. Plast Reconstr Surg 2004;114:339-50. https://doi.org/10.1097/01.PRS.0000131984.55825.9D
  16. Ariyan S. Further experiences with the pectoralis major myocutaneous flap for the immediate repair of defects from excisions of head and neck cancers. Plast Reconstr Surg 1979;64:605-12. https://doi.org/10.1097/00006534-197964050-00002
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피인용 문헌

  1. Perforator Flap versus Conventional Flap vol.30, pp.5, 2012, https://doi.org/10.3346/jkms.2015.30.5.514
  2. Free Flap Reconstruction of a Challenging Defect in the Posterior Cervicothoracic Region Using the Transverse Cervical Artery vol.25, pp.4, 2012, https://doi.org/10.12790/ahm.20.0059
  3. Propeller Dorsal Intercostal Artery Perforator Flap for an Extensive Defect on the Back Following Malignant Peripheral Nerve Sheath Tumor Resection: A Case Report vol.26, pp.1, 2012, https://doi.org/10.12790/ahm.20.0068
  4. Propeller and Pre-expanded Propeller Use of a Transversely Oriented Upper Trapezius Perforator Flap in Head and Neck Reconstruction: Clinical Experience and Review of Vascular Anatomy of the Supraspin vol.74, pp.7, 2012, https://doi.org/10.1016/j.bjps.2021.03.126