title: Usefulness of myofascial flap without skin in contemporary oral and maxillofacial reconstruction.
abstract: OBJECTIVE
  Pedicle myofascial graft should be considered in contemporary oral and maxillofacial reconstruction for the following reasons: 1) the pedicle myofascial unit is reliable and easily handled; 2) on the grafted myofascia in the oral cavity, the mucosa regenerates naturally with regard to suppleness and surface characteristics; and 3) vascularized myofascial coverage of tissues or materials is useful in some clinical situations. The purpose of this retrospective study was to evaluate the usefulness of this graft material.
  
  
  METHODS
  Using myofascial flaps from the pectoralis major muscle in 15 patients and from the platysma muscle in 11 patients, several types of reconstructive procedures were conducted in the Department of Oral and Maxillofacial Surgery, Wakayama Medical University.
  
  
  RESULTS
  Myofascial tissue was used to cover the surgical defect and for regeneration of oral mucosa (24 patients), to prevent exposure of the mandibular reconstruction plate (4 patients), for prevention of wound breakdown and secondary infection in the oral cavity (2 patients), for vascularized coverage of free grafted autologous bone (2 patients), and for protection of large vessels after radical neck dissection (9 patients). Although partial flap necrosis or wound dehiscence was noticed in 3 patients with a platysma-myofascial graft, the healing process of all patients was favorable and required no additional operations. This procedure is most suitable for the reconstruction of small to medium-sized soft tissue defects in the oral cavity, because it induces the formation of nearly normal mucosa through epithelial regeneration without clear scar formation.
  
  
  CONCLUSIONS
  Myofascial flap is a useful option in certain oral and maxillofacial reconstruction cases in which mucosal regeneration and/or vascularized soft tissue coverage are required.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Wakayama Medical University, Wakayama-shi, Japan. twada@wakayama-med.ac.jp
authors.forename: Takeshi
authors.initials: T
authors.lastname: Wada
authors.forename: Ken
authors.initials: K
authors.lastname: Nakatani
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Hiraishi
authors.forename: Kenji
authors.initials: K
authors.lastname: Negoro
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Iwagami
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Fujita
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009055:Mouth / Q000601:surgery*; D009061:Mouth Mucosa / Q000473:pathology / Q000502:physiology; D009062:Mouth Neoplasms / Q000601:surgery*; D009334:Neck Muscles; D019647:Oral Surgical Procedures / Q000379:methods*; D010369:Pectoralis Muscles; D019651:Plastic Surgery Procedures; D012038:Regeneration; D013524:Surgical Flaps