title: The superior thyroid artery perforator flap:  anatomical study and clinical series.
abstract: The redundant tissues of the anterior neck are well suited as a donor site for fasciocutaneous flaps in head and neck reconstruction, with similar skin quality and numerous underlying perforators. However, historic cadaveric research has limited the use of this as a donor site for the design of long and/or large flaps for fear of vascular compromise. The authors undertook an anatomical study to identify the vascular basis for such flaps and have modified previous designs to offer the versatile and reliable superior thyroid artery perforator (STAP) flap. Forty-five consecutive computed tomographic angiograms of the neck were reviewed, assessing the vascular supply of the anterior skin of the neck. Based on these findings, eight consecutive patients underwent head and neck reconstruction using a flap based on the dominant perforator of the region. In all cases, a perforator larger than 0.5 mm was identified within a 2-cm radius of the midpoint of the sternocleidomastoid muscle at its anterior border. This perforator was seen to emerge through the investing layer of deep cervical fascia as a fasciocutaneous perforator and to perforate the platysma on its ipsilateral side of the neck, proximal to the midline. This was seen to be a superior thyroid artery perforator in 89 of 90 sides and an inferior thyroid artery perforator in one case. Eight consecutive patients underwent preoperative imaging and successful flap planning and execution based on this dominant perforator. The superior thyroid artery perforator (STAP) flap demonstrates reliable vascular anatomy and is well suited to reconstruction of a broad range of head and neck defects.
  
  
  METHODS
  Therapeutic, IV.
authors.affiliation: East Melbourne, Victoria, Australia From the Department of Surgical Oncology, Peter MacCallum Cancer Centre.
authors.forename: Jeremy L
authors.initials: JL
authors.lastname: Wilson
authors.forename: Warren M
authors.initials: WM
authors.lastname: Rozen
authors.forename: Richard
authors.initials: R
authors.lastname: Ross
authors.forename: Michael W
authors.initials: MW
authors.lastname: Findlay
authors.forename: Mark W
authors.initials: MW
authors.lastname: Ashton
authors.forename: Felix C
authors.initials: FC
authors.lastname: Behan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001158:Arteries; D006801:Humans; D008875:Middle Aged; D009333:Neck / Q000098:blood supply* / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000098:blood supply*; D013961:Thyroid Gland / Q000098:blood supply