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A Myocutaneous Flap for Selected Head and Neck Reconstruction

Michael Friedman, MD; Vytenis Grybauskas, MD; Emanuel Skolnik, MD; Arthur Katz, MD; Thomas Chilis, MD; Dean M. Toriumi, MD

Arch Otolaryngol Head Neck Surg. 1986;112(3):309-315.

Abstract
• Reconstruction in head and neck surgery has been greatly advanced with the use of the pectoralis major and trapezius myocutaneous flaps. Most surgical defects can be repaired with one of these flaps alone, or in conjunction with cutaneous flaps. Specific problems, however, occur that cannot be successfully reconstructed by these standard flaps. The traditional scalp flaps are cutaneous flaps. Use of these flaps is limited because of their shortened arc of rotation and accompanying forehead deformity. Three patients underwent reconstruction with a parietal occipital nape of neck myocutaneous flap. Its advantages include the following: (1) large segments of hairless skin from the contralateral side of the neck can be used, (2) an extensive arc of rotation and distance can be achieved with excellent vascularity in the overlying skin, and (3) cosmetic results are superior. Angiographic studies were used to demonstrate the vascular pattern and supply to this flap. Cadaver dissections were performed to determine the pattern of distribution of the perforating vessels to the skin from underlying muscle.

(Arch Otolaryngol Head Neck Surg 1986;112:309-315)

Author Affiliations
From the Department of Otolaryngology—Head and Neck Surgery, University of Illinois College of Medicine and University of Illinois Hospital, Chicago (Drs Friedman, Grybauskas, and Skolnik); the Departments of Otolaryngology (Drs Friedman and Grybauskas) and Pathology (Dr Chilis), Illinois Masonic Medical Center, Chicago; the Department of Otolaryngology, Ingalls Memorial Hospital, Harvey, Ill (Dr Katz); and the Department of Otolaryngology—Head and Neck Surgery, Northwestern University Medical School, Chicago (Dr Toriumi).

Footnotes
Accepted for publication Aug 27, 1985.

Read in part before the American Academy of Facial Plastic and Reconstructive Surgery, Palm Beach, Fla, May 12, 1984.

Reprint requests to Department of Otolaryngology—Head and Neck Surgery, University of Illinois, 1855 W Taylor St, Chicago, IL 60612 (Dr Friedman).

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