Research Article
Volume 3 Issue 12 - 2020
Trapezius Muscle System; Vascularity and Angiosomes Makes its Usefulness as a Flap in Reconstruction of Head and Neck Defects
Andrés C Limardo*, Luis Blanco, Jose Menendez and Adrían Ortega
Surgeon of Head and Neck of the Professor, A. Posadas Hospital, General Surgery Department/Head and Neck Surgery Service. Professor, A. Posadas Hospital, El Palomar, Buenos Aires, Argentina
*Corresponding Author: Andrés C Limardo, Surgeon of Head and Neck of the Professor, A. Posadas Hospital, General Surgery Department/Head and Neck Surgery Service. Professor, A. Posadas Hospital, El Palomar, Buenos Aires, Argentina.
Received: November 19, 2020; Published: November 30, 2020




Abstract

Background: The concept of angiosome delimits the body in three-dimensional vascular spaces that involve cutaneous, subcutaneous and muscular territories, irrigated by specific arteries and drained by specific accessory veins. The ideal muscle to describe this concept is the trapezius pedicled muscle flap (TPMF) that presents three angiosomes and flaps; Superior trapezius flap (STF), Lateral island trapezius flap (LITF) and Lower trapezius island musculocutaneous (LTIMF). The objective is to carry out a bibliographic review of the TPMF and its usefulness in reconstruction in head and neck surgery.

Materials And Methods: A bibliographic and medical record review was carried out from January 2010 to December 2019.

Results: 52 articles in PUBMED-MEDLINE and three patients from our experience were reviewed. In two, a LITF flap was used after resection of parotid tumors and the other required a LTIMF flap due to a tumor in the neck.

Discussion: Mathes and Nahai classified CPT as type II. The STF is based on paraspinous perforators and the occipital artery, it has random vascularity and it is highly reliable and serves as a source of coverage for posterolateral neck defects that do not extend more medially than the midline. The LITF, based solely on the transverse cervical artery (TCA). It arises from the thyrocervical trunk and crosses laterally low in the neck, superficial to the prevertebral fascia. The main use is for lateral and anterior neck defects. The LTIMF is vascularized by the dorso-scapular artery (DSA). It is a deep collateral branch of TCA. It is used for the reconstruction of neck, oral cavity, scalp and cheek defects.

Conclusion: The TPMF is a versatile flap. Thanks to its characteristics reliable anatomical techniques can be used safely for the reconstruction of coverage defects head and neck complexes. Can be used as a first choice or as an alternative when other procedures have failed and in patients in whom it is not possible to apply a reconstructive process based on microsurgical procedures. The concept of angiosome provides a safe idea in the flap design of the TPMF.

Keywords: Trapezius Pedicled Musculocutaneous Flap; Angiosomes; Trapezius Muscle System

References

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    12. Lynch JR., et al. “The lower trapezius musculocutaneous flap revisited: versatile coverage for complicated wounds to the posterior cervical and occipital regions based on the deep branch of the transverse cervical artery”. Plastic and Reconstructive Surgery 2 (2002): 444-450.
    13. Haas F., et al. “The lower trapezius musculocutaneous flap from pedicled to free flap: anatomical basis and clinical applications based on the dorsal scapular artery”. Plastic and Reconstructive Surgery 6 (2004): 1580-1590.
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Citation: Andrés C Limardo., et al. “Trapezius Muscle System; Vascularity and Angiosomes Makes its Usefulness as a Flap in Reconstruction of Head and Neck Defects”. EC Clinical and Experimental Anatomy 3.12 (2020): 27-36.

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