PLATYSMA MYOCUTANEOUS FLAP INCLUDING THE EXTERNAL JUGULAR-VEIN WITH SPECIAL REFERENCE TO NECK DISSECTION

Although platysma myocutaneous flap (PTMCF) is suitable for a small in traoral defect, combination with neck dissection (ND) decreases the vi ability. Therefore, a version of PTMCF was devised to increase the via bility. This version consists of three points: preservation of the ext ernal jugular vein (EJV), preservation of the facial artery after skel etonization from the submandibular gland, and a new incision around th e flap. This procedure was applied to 21 patients with intraoral cance r. All 21 patients underwent some kind of ND. The average viable area of transferred skin was 80%. This rate was significantly better than t hat for 46 previous cases using Farr's modification with ND, in which the facial artery was divided. Viability of the flaps was analyzed by the vessels presented, especially by EJV. ND is not a contraindication with this version.