Background : The platysma myocutaneous pedicled flap is not commonly used in head and neck reconstruction, but should be considered for reconstruction of small and medium-sized defects in the oral cavity. The advantages of the platysma flap is that it is of appropriate thickness, has minimal donor site complications, little post-operative scarring and ideal colour match. Rotation of the platysma muscle means that it can be used to reconstruct a number of different sites, including the lower lip, floor of mouth, ventral tongue and lower third of the face. Contraindications include previous radiotherapy and surgery to the head and neck, neoadjuvant chemotherapy, nodal disease and large defects.
Case series : We present six cases, illustrated with clinical photographs, demonstrating the use of the platysma flap in the reconstruction of various intraoral defects. No post-operative complications occurred, except for one case in which the skin was lost, however the underlying muscle remained viable and the area has healed with a good result. There were no donor site complications. No further surgery was required in any of the cases due to flap failure.
Literature review : Several retrospective, multicentre studies have shown platysma flaps to be effective. Complications have been described, which makes patient selection imperative.
Conclusions : Further studies on the long term success of platysma flaps are required, however, good results have been achieved to date. We propose that due to the versatility and reported success of this technique it should be used more frequently and in cases where free flap reconstruction may be less suitable.
Key words : pedicled flap; platysma flap; reconstruction