Superior trapezius myocutaneous flap: an alternative for head and neck reconstruction. A descriptive technical case...

Reconstruction of complex head and neck defects is particularly challenging in patients with significant comorbidities, prior surgery, and radiotherapy, especially when microsurgical reconstruction is not feasible. This study aims to report our experience with the superior trapezius flap as an alternative reconstructive option and to assess its outcomes.

A retrospective, descriptive observational study was conducted including 12 patients who underwent reconstruction with a superior trapezius flap between 2015 and 2023. Demographic data, clinical characteristics, operative variables, complications, and outcomes were analyzed using descriptive statistics.

The mean age was 62.2 years; and 75% of patients were male. Most defects were related to malignant head and neck tumors (83.3%). A high prevalence of comorbidities was observed, including poor general condition (75%), malnutrition (50%), smoking (75%), and alcohol consumption (58.3%). Previous radiotherapy and prior surgery were present in 75% of cases, and 50% had undergone neck dissection. Mean operative time was 2.34 ± 0.38 h, and mean hospital stay was 17.4 ± 12.86 days. Initial reconstruction was successful without complications in 66.7% of cases; 33.3% required reintervention, with only one complete flap failure. Patient satisfaction was high (83.3%), and no significant donor-site morbidity was observed.

The superior trapezius flap is a valuable alternative for reconstruction of complex head and neck defects, particularly after neck dissection or radiotherapy. It offers effective coverage in high-risk patients with low donor-site morbidity, short operative time, and high patient satisfaction.