title: Lower Trapezius Flap for Reconstruction of Posterior Scalp and Neck Defects after Complex Occipital-Cervical Surgeries.
abstract: Objectives To review the indications, techniques, and outcomes for a series of patients in whom the lower trapezius flaps was used for repair of complex posterior scalp and neck defects after posterior occipital-cervical surgeries. Design Retrospective case series. Setting Tertiary academic hospital. Participants A retrospective review of cases that required complex occipital-cervical repair was performed to identify patients who underwent reconstruction using the lower trapezius flap. Data collected included demographics, clinical presentations, surgical anatomy, operative techniques, and outcomes with review of the pertinent literature. Outcomes Nine patients who underwent reconstruction using the lower trapezius flap were identified. Prior surgical interventions included five complex tumor resections, two patients with multiple instrumented cervical spine surgeries, one patient with a craniotomy for attempted extracranial to intracranial arterial bypass for a basilar aneurysm repair, and a posterior occipital-cervical decompression after trauma. During the median follow-up period of 7 months, all nine single-stage reconstructions resulted in successful healing without major surgical complications. Conclusion Lower trapezius island flaps provide a reliable option for the reconstruction of complex scalp and neck defects that develop after complex occipital-cervical surgeries.
authors.affiliation: Department of Otolaryngology, Washington University, St. Louis, Missouri, United States.
authors.forename: Joseph
authors.initials: J
authors.lastname: Zenga
authors.affiliation: Department of Otolaryngology, Washington University, St. Louis, Missouri, United States.
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Sharon
authors.affiliation: Department of Neurological Surgery, Washington University, St. Louis, Missouri, United States.
authors.forename: Paul
authors.initials: P
authors.lastname: Santiago
authors.affiliation: Department of Otolaryngology, Washington University, St. Louis, Missouri, United States.
authors.forename: Brian
authors.initials: B
authors.lastname: Nussenbaum
authors.affiliation: Department of Otolaryngology, Washington University, St. Louis, Missouri, United States.
authors.forename: Bruce H
authors.initials: BH
authors.lastname: Haughey
authors.affiliation: Department of Plastic Surgery, Washington University, St. Louis, Missouri, United States.
authors.forename: Ida K
authors.initials: IK
authors.lastname: Fox
authors.affiliation: Department of Plastic Surgery, Washington University, St. Louis, Missouri, United States.
authors.forename: Terence M
authors.initials: TM
authors.lastname: Myckatyn
authors.affiliation: Department of Otolaryngology, Washington University, St. Louis, Missouri, United States.
authors.forename: Jason A
authors.initials: JA
authors.lastname: Diaz
authors.affiliation: Department of Neurological Surgery, Washington University, St. Louis, Missouri, United States.
authors.forename: Michael R
authors.initials: MR
authors.lastname: Chicoine
keywords: regional flap; scalp; trapezius; wound