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The versatile application of cervicofacial and cervicothoracic rotation flaps in head and neck surgery

DOI: 10.1186/1477-7819-9-135

Keywords: cervicofacial flap, cervicothoracic flap, head and neck, reconstruction

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Abstract:

Twenty-one consecutive patients who underwent repair of a variety of defects of the head and neck with cervicofacial or cervicothoracic flaps in our hospital from 2006 to 2009 were retrospectively analysed. Statistics pertaining to the patients' clinical factors were gathered.Cheek neoplasms are the most common indication for cervicofacial and cervicothoracic rotation flaps, followed by parotid tumours. Among the 12 patients with medical comorbidities, the most common was hypertension. Defects ranging from 1.5 cm × 1.5 cm to 7 cm × 6 cm were reconstructed by cervicofacial flap, and defects from 3 cm × 2 cm to 16 cm × 7 cm were reconstructed by cervicothoracic flap. The two flaps also exhibited versatility in these reconstructions. When combined with the pectoralis major myocutaneous flap, the cervicothoracic flap could repair through-and-through cheek defects, and in combination with a temporalis myofacial flap, the cervicofacial flap was able to cover orbital defects. Additionally, 95% patients were satisfied with their resulting contour results.Cervicofacial and cervicothoracic flaps provide a technically simple, reliable, safe, efficient and cosmetic means to reconstruct defects of the head and neck.The variable surgical defects that can result from head and neck operations necessitate a broad range of surgical reconstructions, ranging from primary closures and pedicle flaps to free tissue transfers. According the distribution of blood supply, the pedicle flap can include random flaps and axial flaps. A random blood supply pattern is needed to maintain a wide pedicle[1]. Therefore, many random flaps, such as cheek advancement-rotation flaps and forehead flaps, have poor mobility and are only suitable for reconstructing small defects. Although axial flaps (e.g., trapezius flaps[2] and pectoralis major myocutaneous flaps (PMMF)[3]) can overcome these limitations, they often appear too bulky or large, result in a poor colour match with the recipient site, and someti

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