Bilateral Pre-expanded Angel-Wing Lower Trapezius Myocutaneous Flaps for Extensive Cervicothoracic Defect...

Area of Science:

• Plastic Surgery
• Reconstructive Surgery
• Head and Neck Surgery

Background:

• Lower trapezius myocutaneous flaps (LTMFs) are standard for head and neck defect reconstruction.
• A single LTMF is often insufficient for extensive bilateral neck and chest wall defects.
• This study evaluates bilateral pre-expanded LTMFs for large cervicothoracic defects.

Purpose of the Study:

• To assess the efficacy and safety of bilateral pre-expanded LTMFs.
• To evaluate reconstructive outcomes for extensive cervicothoracic defects.
• To present surgical experience with this technique.

Main Methods:

• Retrospective study of 10 patients undergoing bilateral pre-expanded LTMF reconstruction (March 2013 - August 2024).
• Data collected included patient demographics, defect characteristics, flap details, and surgical outcomes.
• Flap transfer via subcutaneous tunnels or propeller fashion was analyzed.

Main Results:

• Ten patients (median age 18 years) underwent reconstruction for large bilateral cervicothoracic defects (median size ~234 cm² per side).
• Tissue expansion duration ranged from 3.5-9.5 months, yielding large flaps (median size ~448 cm² per side).
• Complete flap survival occurred in 90% of cases; one patient had flap tip necrosis.

Conclusions:

• Bilateral pre-expanded LTMFs are a reliable option for extensive cervicothoracic defects.
• The technique provides satisfactory functional and aesthetic outcomes.
• This method expands reconstructive possibilities for complex defects.