Platysma myocutaneous flap for intraoral and surface reconstruction

Different procedures have been described for facial and oral reconstruction after malignant tumor removal, such as skin grafts and local and distal staged flaps. Myocutaneous island or free flaps are the method of choice for these reconstructions. Our experience concerns the use of the platysma myocutaneous flap in 12 patients after intraoral and extraoral malignant tumor resection. Six patients had squamous cell carcinomas, i.e., 2 malignant melanomas of the skin and 4 squamous cell carcinomas of the oral mucosa. The complete tumor resection was controlled by frozen-section biopsy in all patients, but for 7 of them a functional or radical neck dissection was performed. We suggest including in the flap the external jugular vein. The results were evaluated from an oncological, functional, and aesthetic point of view. We noticed 2 recurrences in a minimum follow-up of 4 years. The functional and aesthetic results were quite satisfactory and no serious complications were noticed in our series. However, the primary disadvantage of this interesting flap is that the dominant vasculature derived from the submental branch of the facial artery is seldom visualized. In spite of this, it should be regarded as very useful for limited intraoral or surface coverage problems in an arc extending 10 cm from the level of the facial artery at the mandible. This arc includes the cheek, the lower lip, the chin, the floor of the mouth, and the mastoid area.