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Vascular Anatomy and Surgical Technique

James L. Netterville, MD; David E. Wood, MD

Arch Otolaryngol Head Neck Surg. 1991;117(1):73-76.

Abstract
• The lower trapezius flap was first described in 1980 based on the transverse cervical artery. The older anatomical literature, however, describes the dorsal scapular artery as a major contributor of blood supply to the skin overlying the lower trapezius fibers. To clarify this, 30 dissections of this vascular region were performed. In 15 of 30 dissections, the dorsal scapular artery was dominant and the distal transverse cervical artery arose from the dorsal scapular. In nine of 30 dissections, the transverse cervical artery was dominant and the distal dorsal scapular artery arose from the transverse cervical. In six of 30 dissections, both proximal arteries were of equal caliber with no distal communication. We describe a surgical technique that makes use of the lower trapezius flap with inclusion of the dorsal scapular artery; this technique greatly extends the usefulness of the lower trapezius flap, while decreasing the morbidity caused by division of the upper portion of the trapezius muscle during flap harvest.

(Arch Otolaryngol Head Neck Surg. 1991;117:73-76)

Author Affiliations
From the Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, Nashville, Tenn (Dr Netterville), and the Department of Otolaryngology, Cleveland (Ohio) Clinics (Dr Wood).

Footnotes
Accepted for publication July 31, 1990.

Presented in part at the annual meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Washington, DC, September 23, 1988.

Reprint requests to Department of Otolaryngology—Head and Neck Surgery, Vanderbilt University Medical Center, S-2100 MCN, Nashville, TN 37232-5555 (Dr Netterville).

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