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Composite cervicofacial flap for reconstruction of complex cheek defects
1Division of Plastic and Reconstructive Surgery, Centre Léon Bérard, Lyon, France.
Annals of Plastic Surgery
|October 12, 1999
Summary
This study introduces a modified cervicofacial flap for complex cheek reconstruction, demonstrating high reliability and adaptability in patients with large defects. The technique offers excellent results with minimal complications, advancing reconstructive surgery possibilities.
Area of Science:
- Plastic Surgery
- Reconstructive Surgery
- Head and Neck Oncology
Background:
- Complex cheek defects pose significant reconstructive challenges.
- The cervicofacial flap is a known reconstructive option, but its adaptability for extensive defects can be limited.
- Evaluating modifications to enhance flap reliability and versatility is crucial.
Observation:
- A modified composite cervicofacial flap technique, based on Mustardé's design, was employed.
- The flap incorporates undermining below the superficial musculoaponeurotic system (SMAS) and includes the platysma muscle.
- The study retrospectively analyzed 7 patients with complex cheek defects (up to 9x7 cm) following malignant lesion excision.
Findings:
- The composite flap demonstrated high reliability, with no distal edge necrosis observed in elderly patients.
- Reconstruction successfully addressed defects involving periosteum and even full-thickness cheek loss.
- A single instance of temporary facial paresis was the only complication; all results were rated as very good.
Implications:
- The modified composite cervicofacial flap offers increased mobility, reliability, and adaptability for complex cheek reconstructions.
- This technique expands reconstructive possibilities, particularly for extensive defects previously considered challenging.
- The findings suggest a significant advancement in achieving high-quality aesthetic and functional outcomes in facial reconstruction.