Application of platysma-based transpositional flap for through-and-through facial defect when the facial artery circulation is blocked or compromised.
OBJECTIVE
A novel use of site-limited platysma-based transpositional flap is demonstrated and discussed for the reconstruction of facial defects.


METHODS
Between January 1985 and January 2001, 342 patients were operated on for advanced oral-oropharyngeal and orofacial cancers. In 6 cases, a platysma-based transpositional flap was used for external closure of facial through-and-through defects. Internally, the saved oral mucosa was used in 4 patients and fasciocutaneous forearm free flaps in 2 patients. The facial artery was blocked in all cases.


RESULTS
The postoperative course was uneventful except in 1 case, when partial loss of the flap was observed intraorally. The externally used transpositional platysma-based flap showed cosmetic and functional advantages: its consistency, color, and texture were similar to those of the original facial tissues, the area of operation was the same, and the donor site was closed primarily.


CONCLUSIONS
The site-limited platysma-based myocutaneous transpositional flap is usable and safe even in those cases in which circulation of the facial artery is damaged or local vascular compromise has occurred and the facial through-and-through defect is extended. The facial reconstruction described is one of several applicable reconstructive methods that may be chosen for special facial defects. The method is not applicable when the neck is radically operated on (radical neck dissection) and/or irradiated. No similar use of platysma-based transpositional flaps has been reported thus far.
Olasz
Lajos
L
Department of Oral and Maxillofacial Surgery, University of Pécs, Pécs, Hungary. lajos.olasz@aok.pte.hu
Szalma
József
J
Lempel
Edina
E
Orsi
Eniko
E
Gelencsér
Gábor
G
Nyárády
Zoltán
Z
D000328:Adult; D001158:Arteries / Q000473:pathology; D005145:Face / Q000098:blood supply / Q000601:surgery*; D005153:Facial Neoplasms / Q000601:surgery; D005205:Fascia / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D005542:Forearm / Q000601:surgery; D058752:Free Tissue Flaps; D006085:Graft Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000637:transplantation; D009062:Mouth Neoplasms / Q000601:surgery; D018482:Muscle, Skeletal / Q000637:transplantation; D009334:Neck Muscles / Q000637:transplantation*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009959:Oropharyngeal Neoplasms / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures / Q000379:methods*; D016038:Skin Transplantation / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply; D020858:Tissue and Organ Harvesting / Q000379:methods; D014945:Wound Healing / Q000502:physiology