The lower trapezius myocutaneous flap for reconstruction after surgery for head and neck cancer : ncl experience

Abstract EN

Purpose : the purpose of this study is to evaluate the lower trapezius myocutaneous flap which is used for reconstruction after surgery for head and neck cancer, as considerable controversy persists regarding the optimal myocutaneous flap for reconstruction of defects resulting from resections in the head and neck.

An ideal pedicled myocutaneous flap should provide high success rate, few complications, low morbidity, short hospitalization and the greatest potential for best aesthetic outcome.

Material and Methods : over a two-year period, (July 1999 to July 2001), the lower trapezius myocutaneous flap was used for reconstruction in 15 head and neck cancer patients at the National Cancer Institute, Cairo University.

Nine patients were males and six were females with a mean age 49.6 years.

Squamous cell cancer was diagnosed in 8 patients (53.3 %), basal cell carcinoma in 3 patients (20 %), adenoid cystic carcinoma in 3 patients, while fibrosarcoma was diagnosed in one patient (6.6 %).

Results : flap survival, complications, ultimate functional and cosmetic outcomes were evaluated.

One patient had total flap loss, while in the other 14 patients it was successful.

Only one patient had a haematoma at the donor site.

All wounds were closed primarily and preservation of the accessory nerve to the superior fibers of the trapezius muscle enabled almost normal abduction of the arm.

Conclusion : the lower trapezius myocutaneous flap is safe, reliable and easy to raise with constant blood supply.

Its functional deficits are minimal and the donor site is closed primarily.