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Official Journal of the Italian Society of Maxillofacial Surgery
Online ISSN 1827-1901
Garzino-Demo P., Tosco P., Iaquinta C., Diaspro A., Fasolis M., Berrone S.
Department of Maxillofacial Surgery University of Turin, Turin, Italy
Aim. The routine need for a variety of local and regional flaps has decreased for intraoral reconstruction with the widespread of microvascular free flaps. However, conventional reconstructive techniques can achieve satisfactory wound level with an acceptable morbility. The myocutaneous platysma flap (PMF) is not new to oral cavity reconstruction. The present paper offers an epicrisis of the authors’ experience.
Methods. Forty-six PMF were used to restore the ventral tongue, floor of the mouth, buccal mucosa, trigonum, lower gingiva. In one case PMF was bilobated for reconstruction of cheek. In our series the flap is limited to those non preventively irradiated patients in whom ipsilateral neck dissection were performed and the ipsilateral facial artery and internal jugular vein were preferably preserved.
Results. Thirty-five patients (76%) were able to resume oral alimentation without swallowing disorders within 15 days. Eleven flaps (23.91%) had postsurgical problems. Full loss occurred in 6 cases (13%). Partial skin loss occurred in five cases (10.8%). These complications prolonged the nasogastric nutrition more than 15 days. In 8 cases (17.4%) where mandibular gingiva was reconstructed a conforming surgery was applied to restore the oral function with dental prostheses.
Conclusion. In our experience the advantages of PMF are the readily available and the easy to harvest. This flap is a relatively simple, highly versatile solution although reliability is not the best. It is advisable for the surgeon to include the PMF as part of his therapeutic arsenal.