TY - JOUR
T1 - Tecnica alternativa per il prelievo del lembo di platisma miocutaneo nell’era dei lembi liberi
T2 - Esperienza clinica in 61 pazienti
AU - Calabrese, Luca
AU - Accorona, Remo
AU - Gazzini, Luca
AU - Giorgetti, Giovanni
AU - Tagliabue, Marta
AU - Bruschini, Roberto
AU - Pietrobon, Giacomo
AU - Ansarin, Mohssen
N1 - Publisher Copyright:
© Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale.
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/6
Y1 - 2020/6
N2 - Reconstruction of oral cavity and oropharyngeal defects following radical surgery for squamous cell carcinoma (SCC) can be achieved by a variety of options. In selected cases myocutaneous platysma flap (MPF) may be a valid choice. However, several anatomical and oncological controversies on the use of this flap are debated. A retrospective study on 61 patients treated between January 2005 and December 2017 in two referral centres in which MPF was used for the reconstruction of defects following surgical resection of SCC of the oral cavity and oropharynx was conducted. The technique of flap harvesting with anatomic details is described. In all cases the submental artery was sacrificed preserving the facial artery. All clinical data were collected. Tumours involved the oral cavity in 95.1% of cases, and the oropharynx in 4.9%. Pathological staging (TNM 7th edition) of tumours was: pT1 (42.6%), pT2 (39.3%), pT3 (4.9%) and pT4a (13.1%). Success rate of the flap was 93.4%. Four (6.5%) patients developed a partial necrosis of the skin paddle without platysma muscle involvement; none required surgical revision. The mean follow-up was 69 months (5153 months). Thirteen patients (21.3%) developed a local recurrence, and in 1 patient was associated with contralateral neck metastasis. The MPF can be a suitable option in head and neck reconstruction of small or medium-sized defects in selected cases. The vascular pedicle can be provided by branches of the facial artery achieving both oncological radicality and optimal flap vascular supply.
AB - Reconstruction of oral cavity and oropharyngeal defects following radical surgery for squamous cell carcinoma (SCC) can be achieved by a variety of options. In selected cases myocutaneous platysma flap (MPF) may be a valid choice. However, several anatomical and oncological controversies on the use of this flap are debated. A retrospective study on 61 patients treated between January 2005 and December 2017 in two referral centres in which MPF was used for the reconstruction of defects following surgical resection of SCC of the oral cavity and oropharynx was conducted. The technique of flap harvesting with anatomic details is described. In all cases the submental artery was sacrificed preserving the facial artery. All clinical data were collected. Tumours involved the oral cavity in 95.1% of cases, and the oropharynx in 4.9%. Pathological staging (TNM 7th edition) of tumours was: pT1 (42.6%), pT2 (39.3%), pT3 (4.9%) and pT4a (13.1%). Success rate of the flap was 93.4%. Four (6.5%) patients developed a partial necrosis of the skin paddle without platysma muscle involvement; none required surgical revision. The mean follow-up was 69 months (5153 months). Thirteen patients (21.3%) developed a local recurrence, and in 1 patient was associated with contralateral neck metastasis. The MPF can be a suitable option in head and neck reconstruction of small or medium-sized defects in selected cases. The vascular pedicle can be provided by branches of the facial artery achieving both oncological radicality and optimal flap vascular supply.
KW - Myocutaneous flap
KW - Oral cavity reconstruction
KW - Platysma flap
KW - Reconstructive surgery
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U2 - 10.14639/0392-100X-N0538
DO - 10.14639/0392-100X-N0538
M3 - Articolo
C2 - 32773778
AN - SCOPUS:85089319407
VL - 40
SP - 173
EP - 180
JO - Acta Otorhinolaryngologica Italica
JF - Acta Otorhinolaryngologica Italica
SN - 0392-100X
IS - 3
ER -