Pseudocyst formation after trapezius myocutaneous flap reconstruction: management with chemical obliteration

A trapezius myocutaneous flap is frequently used in head and neck reconstruction surgery. Pseudocyst formation over the flap donor area after its dissection is a rare occurrence. When a cyst occurs after flap application in reconstructive surgery for head and neck malignancies, or is noted concomitantly with a local recurrence of a head and neck malignancy, differentiation between malignant effusion and pseudocyst is important. Differentiation is made by cytologic and biochemical analyses of the cystic contents. Instillation of a chemical irritant can successfully obliterate such pseudocysts.