Efficacy of Platysma Myocutaneous Flap in Advanced Oral Submucous Fibrosis - A Prospective Study

Platysma myocutaneous flap used for intraoral reconstruction is an axial-pattern flap based on the submental branch of the facial artery; however, its vascular anatomy is complex in nature. Its efficacy in the reconstruction of oral defects following oral cancer resection is well established, even after facial artery ligation. The aim of this study is to evaluate the efficacy of platysma myocutaneous flap in oral submucous fibrosis (OSMF) patients.

The study included 85 OSMF patients (Grades III and IV). Platysma myocutaneous flap was used for the reconstruction of fibrotomy defects in all patients. All patients were followed up for a period of up to one year. Mouth opening was the chief parameter evaluated intraoperatively and postoperatively. The complications such as flap dehiscence, partial skin loss, tip necrosis, haematoma and paraesthesia at the donor site were also recorded.

The mean mouth opening value (in mm) increased from 13.00 ± 1.93 and 6.50 ± 2.35 to 32.72 ± 5.19 and 31.20 ± 4.77 at the end of one year in Grade III and IV groups, respectively. A gradual improvement in pain score was noted. Only minor complications occurred in 8.2% patients. Major flap loss was not seen in our series.

Proper dissection plane, avoiding muscle tearing during flap elevation, maintaining adequate pedicle, creating a tunnel of sufficient width and proper intraoral flap orientation are the major factors affecting flap success rates. Our study demonstrated that the platysma myocutaneous flap is a promising and effective option for reconstructing buccal mucosa defects in OSMF patients.