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Neck

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Cutaneous Flaps in Head and Neck Reconstruction

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Abstract

The cervical skin serves as an abundant source of flap material that can be transferred to close large facial defects. The superficial neck anatomic structures that are involved in skin flap surgery are the skin and the subcutaneous tissue, the platysma muscle, the investing layer of the deep cervical fascia, and the superficially located neck muscles. The skin of the neck is supplied by musculocutaneous and direct cutaneous perforators of branches of the external carotid artery and of the thyrocervical trunk of the subclavian artery. Important motor and sensory nerves that are located in a superficial level at the neck are involved in the surgery of the flaps that are derived from the neck. The regional neck flaps provide skin quite similar in color, texture, and thickness regarding the skin of the lateral face and must be the first choice when a local flap is not sufficient to reconstruct a sizeable defect.

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References

  • Agarwal A, Schneck CD, Kelley DJ (2004) Venous drainage of the platysma myocutaneous flap. Otolaryngol Head Neck Surg 130(3):357–359

    Article  PubMed  Google Scholar 

  • Ariyan S (1979) The pectoralis major myocutaneous flap. A versatile flap for reconstruction in the head and neck. Plast Reconstr Surg 63(1):73–81

    Article  CAS  PubMed  Google Scholar 

  • Ariyan S (1997) The transverse platysma myocutaneous flap for head and neck reconstruction. Plast Reconstr Surg 99(2):340–347

    Article  CAS  PubMed  Google Scholar 

  • Ariyan S (2003) The transverse platysma myocutaneous flap for head and neck reconstruction: an update. Plast Reconstr Surg 111(1):378–380

    Article  PubMed  Google Scholar 

  • Baur DA, Helman JI (2002) The posteriorly based platysma flap in oral and facial reconstruction: A case series. J Oral Maxillofac Surg 60(10):1147–1150

    Article  PubMed  Google Scholar 

  • Coleman JJ 3rd, Nahai F, Mathes SJ (1982) Platysma musculocutaneous flap: clinical and anatomic considerations in head and neck reconstruction. Am J Surg 144(4):477–481

    Article  PubMed  Google Scholar 

  • Coleman JJ 3rd, Jurkiewicz MJ, Nahai F, Mathes SJ (1983) The platysma musculocutaneous flap: experience with 24 cases. Plast Reconstr Surg 72(3):315–323

    Article  PubMed  Google Scholar 

  • Conley JJ, Lanier DM, Tinsley P Jr (1986) Platysma myocutaneous flap revisited. Arch Otolaryngol Head Neck Surg 112(7):711–713

    Article  CAS  PubMed  Google Scholar 

  • Curran AJ, Neligan P, Gullane PJ (1997) Submental artery island flap. Laryngoscope 107(11Pt1):1545–1549

    Article  CAS  PubMed  Google Scholar 

  • De Castro CC (1980) The anatomy of the platysma muscle. Plast Reconstr Surg 66(5):680–683

    Article  PubMed  Google Scholar 

  • Eliachar I, Marcovich A, Har Shai Y, Lindenbaum E (1984) Arterial blood supply to the infrahyoid muscles: an anatomical study. Head Neck Surg 7(1):8–14

    Article  CAS  PubMed  Google Scholar 

  • Faltaous AA, Yetman RJ (1996) The submental artery flap: an anatomic study. Plast Reconstr Surg 97(1):56–60

    Article  CAS  PubMed  Google Scholar 

  • Fróes LB, Castro De Tolosa EM, Camargo RD, Pompeu E, Liberti EA (1999) Blood supply to the human sternocleidomastoid muscle by the sternocleidomastoid branch of the occipital artery. Clin Anat 12(6):412–416

    Article  PubMed  Google Scholar 

  • Futrell JW, Johns ME, Edgerton MT, Cantrell RW, Fitz-Hugh GS (1978) Platysma myocutaneous flap for intraoral reconstruction. Am J Surg 136(4):504–507

    Article  CAS  PubMed  Google Scholar 

  • Gersuny R (1887) Plasticher Ersatz der Wangenscheimhaut. Zentralbl Chir 14:706–708

    Google Scholar 

  • Görmüs G, BayramoÄŸlu A, Aldur MM, Celik HH, Maral T, Sargon MF, Demiryürek D, Aksit MD (2004) Vascular pedicles of infrahyoid muscles: an anatomical study. Clin Anat 17(3):214–217

    Article  PubMed  Google Scholar 

  • Haas F, Weiglein A, Schwarzl F, Scharnagl E (2004) The lower trapezius musculocutaneous flap from pedicled to free flap: anatomical basis and clinical applications based on the dorsal scapular artery. Plast Reconstr Surg 113(6):1580–1590

    Article  PubMed  Google Scholar 

  • Hatef DA, Koshy JC, Sandoval SE, Echo AP, Izaddoost SA, Hollier LH (2009) The submental fat compartment of the neck. Semin Plast Surg 23(4):288–291

    Article  PubMed Central  PubMed  Google Scholar 

  • Hu KS, Song WC, Kim SH, Choi SW, Han SH, Paik DJ, Kim HJ, Koh KS (2006) Branching patterns of the arterial branches supplying the middle vascular pedicle of the sternocleidomastoid muscle: a topographic anatomical study with surgical applications for the use of pedicles osteomuscular flaps. Surg Radiol Anat 28(1):7–12

    Article  CAS  PubMed  Google Scholar 

  • Hurwitz DJ, Rabson JA, Futrell JW (1983) The anatomic basis for the platysma skin flap. Plast Reconstr Surg 72(3):302–314

    Article  CAS  PubMed  Google Scholar 

  • Imanishi N, Nakajima H, Kishi K, Chang H, Aiso S (2005) Is the platysma flap musculocutaneous? Angiographic study of the platysma. Plast Reconstr Surg 115(4):1018–1024

    Article  CAS  PubMed  Google Scholar 

  • Kierner AC, Aigner M, Zelenka I, Riedl G, Burian M (1999) The blood supply of the sternocleidomastoid muscle and its clinical implications. Arch Surg 134(2):144–147

    Article  CAS  PubMed  Google Scholar 

  • Kim JT, Kim SK, Koshima I, Moriguchi T (2002a) An anatomic study and clinical applications of the reversed submental perforator-based island flap. Plast Reconstr Surg 109(7):2204–2210

    Article  PubMed  Google Scholar 

  • Kim HJ, Koh KS, Oh CS, Hu KS, Kang JW, Chung IH (2002b) Emerging patterns of the cervical cutaneous nerves in Asians. Int J Oral Maxillofac Surg 31(1):53–56

    Article  CAS  PubMed  Google Scholar 

  • Koch M, Künzel J, Mantsopoulos K, Zenk J, Iro H (2012) Defect closure after oral and pharyngeal tumor resection with the superiorly pedicled myocutaneous platysma flap: indications, technique, and complications. Eur Arch Otorhinolaryngol 269(9):2111–2119

    Article  PubMed  Google Scholar 

  • Lasjaunias P, Berenstein A, Doyon D (1979) Normal functional anatomy of the facial artery. Radiology 133(3Pt1):631–638

    CAS  PubMed  Google Scholar 

  • Magden O, Edizer M, Tayfur V, Atabey A (2004) Anatomic study of the vasculature of the submental artery flap. Plast Reconstr Surg 114(7):1719–1723

    Article  PubMed  Google Scholar 

  • Martin D, Pascal JF, Baudet J, Mondie JM, Farhat JB, Athoum A, Le Gaillard P, Peri G (1993) The submental island flap: a new donor site. Anatomy and clinical applications as a free or pedicled flap. Plast Reconstr Surg 92(5):867–873

    Article  CAS  PubMed  Google Scholar 

  • McGuirt WF, Matthews BL, Brody JA, May JS (1991) Platysma myocutaneous flap: caveats reexamined. Laryngoscope 101(11):1238–1244

    Article  CAS  PubMed  Google Scholar 

  • Nash L, Nicholson HD, Zhang M (2005) Does the investing layer of the deep cervical fascia exist? Anesthesiology 103(5):962–968

    Article  PubMed  Google Scholar 

  • Owsley JQ, Agarwal CA (2008) Safely navigating around the facial nerve in three dimensions. Clin Plast Surg 35(4):469–477

    Article  PubMed  Google Scholar 

  • Ozgur Z, Govsa F, Celik S, Ozgur T (2009) Clinically relevant variations of the superior thyroid artery: an anatomic guide for surgical neck dissection. Surg Radiol Anat 31(3):151–159

    Article  PubMed  Google Scholar 

  • Pilsl U, Anderhuber F (2010) The chin and adjacent fat compartments. Dermatol Surg 36(2):214–218

    Article  CAS  PubMed  Google Scholar 

  • Pinar YA, Bilge O, Govsa F (2005a) Anatomic study of the blood supply of perioral region. Clin Anat 18(5):330–339

    Article  PubMed  Google Scholar 

  • Pinar YA, Govsa F, Bilge O (2005b) The anatomical features and surgical usage of the submental artery. Surg Radiol Anat 27(3):201–205

    Article  Google Scholar 

  • Rabson JA, Hurwitz DJ, Futrell JW (1985) The cutaneous blood supply of the neck: relevance to incision planning and surgical reconstruction. Br J Plast Surg 38(2):208–219

    Article  CAS  PubMed  Google Scholar 

  • Ruark DS, McClairen WC Jr, Schlehaider UK, Abdel-Misih RZ (1993) Head and neck reconstruction using the platysma myocutaneous flap. Am J Surg 165(6):713–718

    Article  CAS  PubMed  Google Scholar 

  • Salinas NL, Jackson O, Dunham B, Bartlett SP (2009) Anatomical dissection and modified Sihler stain of the lower branches of the facial nerve. Plast Reconstr Surg 124(6):1905–1915

    Article  CAS  PubMed  Google Scholar 

  • Shah AR, Rosenberg D (2009) Defining the facial extent of the platysma muscle: a review of 71 consecutive face-lifts. Arch Facial Plast Surg 11(6):405–408

    Article  PubMed  Google Scholar 

  • Shima H, von Luedinghausen M, Ohno K, Michi K (1998) Anatomy of microvascular anastomosis in the neck. Plast Reconstr Surg 101(1):33–41

    Article  CAS  PubMed  Google Scholar 

  • Standring S (2008) Gray’s anatomy. The anatomical basis of clinical practice, 40th edn. Churchill Livingstone-Elsevier, Edinburg

    Google Scholar 

  • Szudek J, Taylor SM (2007) Systematic review of the platysma myocutaneous flap for head and neck reconstruction. Arch Otolaryngol Head Neck Surg 133(7):655–661

    Article  PubMed  Google Scholar 

  • Tang WJ, Sun SQ, Wang XL, Sun YX, Huang HX (2012) An applied anatomical study on the recurrent laryngeal nerve and inferior thyroid artery. Surg Radiol Anat 34(4):325–332

    Article  PubMed  Google Scholar 

  • Tessier P, Matthews DC, Kamerer D Jr, Ciminello FS, Gargano F, Wolfe SA (2011) Platysma-based myocutaneous clavicular island flap for intraoral reconstruction. Ann Plast Surg 67(6):S55–S69

    Article  CAS  PubMed  Google Scholar 

  • Thomaidis VK et al (2006) The use of myocutaneous platysmal flap in the reconstruction of intraoral defects after tumor resection combined with supraomohyoid neck dissection (article in Greek). Hell Arch Oral Maxillofac Surg 7(3):143–154

    Google Scholar 

  • Uehara M, Helman JI, Lillie JH, Brooks SL (2001) Blood supply to the platysma muscle flap: an anatomic study with clinical correlation. J Oral Maxillofac Surg 59(6):642–646

    Article  CAS  PubMed  Google Scholar 

  • Wilson JL, Rozen WM, Ross R, Findlay MW, Ashton MW, Behan FC (2012) The superior thyroid artery perforator flap: anatomical study and clinical series. Plast Reconstr Surg 129(3):641–646

    Article  CAS  PubMed  Google Scholar 

  • Zhang M, Lee AS (2002) The investing layer of the deep cervical fascia does not exist between the sternocleidomastoid and trapezius muscles. Otolaryngol Head Neck Surg 127(5):452–454

    Article  PubMed  Google Scholar 

  • Zhao Z, Li S, Xu J, Li Y, Huang W, Yang M, Mu L, Liu Y, Zhai H, Jin J, Li J, Li J, Fu X (2000) Color Doppler flow imaging of the facial artery and vein. Plast Reconstr Surg 106(6):1249–1253

    Article  CAS  PubMed  Google Scholar 

  • Ziarah HA, Atkinson ME (1981) The surgical anatomy of the cervical branch of the facial nerve. Br J Oral Surg 19(3):171–179

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Anatomy, Medical School Democritus University of Thrace, Alexandroupolis, Evros, Greece

    Vasilios K. Thomaidis MD, DDS, PhD

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  1. Vasilios K. Thomaidis MD, DDS, PhD
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Thomaidis, V.K. (2014). Neck. In: Cutaneous Flaps in Head and Neck Reconstruction. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-41254-7_8

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  • DOI: https://doi.org/10.1007/978-3-642-41254-7_8

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-41253-0

  • Online ISBN: 978-3-642-41254-7

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