Objective: This study aimed to explore the main features and advantages of the muscle pedicled platysma myocutaneous flap (PMF), the degree of improvement of flap harvest. To evaluate the application value of the flap in the reconstruction of buccal mucosa carcinoma defects.
Methods: Twenty-three patients received PMF with MacFee incision to reconstruct buccal mucosa defects that were caused by the resection of precancer lesions and benign and malignant tumors from August 2012 to April 2015. When elevating the cervical skin from the platysma, most of the subcutaneous tissue was preserved on the muscle. The continuity of the facial vessels was retained. The external jugular vein was preserved on the reverse side of the platysma.
Results: Twenty-one flaps survived completely, whereas the other two flaps presented partial skin loss. Two patients showed disturbed wound healing in the neck. Secondary healing was achieved after attentive wound care. All patients were followed up from 11 to 43 months. The function of the recipient sites recovered well. Except for the two patients with large-area scarring in the neck, the remaining cases presented satisfactory neck contours. No relapses were observed during the follow-up period.
Conclusions: Compared with the traditional PMF, the muscle pedicled PMF provides a larger skin paddle and presents a better aesthetic and functional effect. Thus, this approach is a novel and ideal option for the restoration of buccal mucosa defects.
目的 探讨肌蒂型颈阔肌肌皮瓣（PMF）的主要特点、优点、皮瓣制备的改良措施，并评价其在颊黏膜缺损修复中的应用价值。方法 选取2012年8月—2015年4月采用经MacFee切口的改良肌蒂型PMF修复因癌前病变及良恶性肿瘤切除导致的颊黏膜缺损23例。掀起皮瓣蒂部皮肤时，将大部分皮下脂肪置于颈阔肌表面；保持面动静脉的连续性；携带颈外静脉在颈阔肌的背面。结果 23例病例中21例皮瓣完全成活，2例皮瓣部分坏死，另有2例颈部伤口愈合不良，经换药处理均二期愈合。所有病例经11~43个月随访，受区功能恢复良好，除2例颈部伤口愈合不良病例遗留较大面积瘢痕外，其余病例颈部外形满意，无局部及颈部复发病例。结论 和传统PMF比较，肌蒂型PMF可提供更大的皮岛面积，功能美学效果更佳，是修复颊黏膜缺损的一种新的理想选择。.
Keywords: MacFee incision; buccal carcinoma; buccal mucosa defect; platysma myocutaneous flap; reconstruction.