The anatomic basis for the innervated mylohyoid/digastric flap in facial reanimation.

This paper describes the anatomy of the neurovascular supply to the mylohyoid and digastric muscle and its potential use for a regional transposition to rehabilitate the paralyzed face and soft-tissue coverage in the head and neck area. The anatomy and the arc of rotation of this flap were determined in ten embalmed cadavers. To further demonstrate the vascular supply, the common carotid was injected with silicone in four additional fresh cadavers. In all specimens, the submental artery and the mylohyoid nerve were the sole contributors to the neurovascular supply of the mylohyoid and digastric muscle. The arc of rotation was an average of 5 cm (range 4 to 6.5 cm), which allowed the flap to be positioned appropriately between the zygomatic arch and the modiolus. From this anatomic study, the mylohyoid/digastric flap has a long enough neurovascular pedicle to be useful in facial reanimation and soft-tissue coverage in the head and neck area.