Cheek reconstruction following facial malignant melanoma surgery with the platysma myocutaneous flap

Int J Oral Maxillofac Surg. 2015 Oct;44(10):1236-9. doi: 10.1016/j.ijom.2015.02.023. Epub 2015 Jul 29.

Abstract

The aim of this study was to evaluate the results of large cheek skin defect reconstruction using a superiorly based platysma myocutaneous flap accompanied by facial artery and vein preservation, following cutaneous head and neck melanoma surgery. This study offers new insight into a procedure that is a viable, but infrequently used reconstruction option. The authors report the cases of 13 consecutive patients with cheek skin defects following melanoma surgery who underwent reconstruction with a superiorly based platysma myocutaneous flap. The procedures were performed at a tertiary clinical centre and a national melanoma surgery referral centre between 2001 and 2008. According to the disease stage, eight patients underwent sentinel lymph node biopsy and five underwent comprehensive neck dissections. All of the patients were monitored for any complications related to the donor and recipient sites. Minor venous congestion of the flap was noted in two patients, with minor marginal skin necrosis in one patient. None of the patients had donor site complications. The superiorly based platysma flap proved to be a safe and reliable option for large cheek defect reconstruction, especially considering that it is a single-stage reconstruction procedure ensuring excellent colour-matching and low donor site morbidity.

Keywords: facial reconstruction; head and neck oncology; midfacial third defects; platysma myocutaneous flap.

MeSH terms

  • Aged
  • Cheek / blood supply*
  • Cheek / surgery*
  • Female
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / surgery*
  • Humans
  • Male
  • Melanoma / pathology
  • Melanoma / surgery*
  • Melanoma, Cutaneous Malignant
  • Middle Aged
  • Myocutaneous Flap / blood supply*
  • Neck Dissection
  • Plastic Surgery Procedures / methods*
  • Postoperative Complications
  • Sentinel Lymph Node Biopsy
  • Skin Neoplasms
  • Treatment Outcome