Department of Otorhinolaryngology, Head and Neck Surgery, University of Erlangen-Nuremberg Medical School, Waldstrasse 1, 91054 Erlangen, Germany.
Eur Arch Otorhinolaryngol. 2012 Sep;269(9):2111-9. doi: 10.1007/s00405-011-1891-5. Epub 2011 Dec 24.
This study evaluated the myocutaneous platysma flap (MPF) as an alternative to free flaps for closing defects after head and neck tumor resection in selected cases. MPFs were used to close small to medium-sized full-thickness oral and pharyngeal defects after surgery for tumors staged cT1-3 (oral cavity 37.1%, oropharynx 24.3%, hypopharynx 38.6%) in 70 patients. Flap-related complications developed in 27% of cases (partial necrosis 7%, total necrosis 3%, salivary fistula 11.4%, bleeding/hematoma 5.7%) and donor-site complications in 10%. Defect closure was adequate in 97%; 62.5% of the patients required intraoperative tracheotomies (closed again in 72.5%). Postoperative swallowing was not significantly disturbed in 72% of the patients. The MPF allows closure of small to medium-sized defects in the head and neck region in selected patients, with acceptable aesthetic and functional outcomes. The success rate (>90%) is comparable with surgical alternatives associated with considerably greater surgical effort and risk.
本研究评估了胸锁乳突肌皮瓣（MPF）作为头颈部肿瘤切除后修复缺陷的游离皮瓣的替代选择，适用于特定病例。在 70 例接受肿瘤分期 cT1-3（口腔 37.1%，口咽 24.3%，下咽 38.6%）手术的患者中，MPF 用于闭合小至中等大小的全层口腔和咽腔缺损。27%的病例出现与皮瓣相关的并发症（部分坏死 7%，完全坏死 3%，涎瘘 11.4%，出血/血肿 5.7%），10%的病例出现供区并发症。97%的病例缺损闭合良好；62.5%的患者需要术中气管切开术（其中 72.5%再次闭合）。72%的患者术后吞咽功能未受到明显干扰。MPF 可在特定患者中闭合头颈部的小至中等大小的缺陷，具有可接受的美学和功能效果。成功率（>90%）与相关的手术替代方案相当，但手术难度和风险要大得多。
