Platysma myocutaneous flap for reconstruction of skin defects in the head and neck

The platysma myocutaneous flap (PMF) is a common reconstructive option for defects in the head and neck region. Its applications have expanded from the reconstruction of intraoral defects to include laryngo-pharyngeal, lip, and cheek defects. The platysma flap can be superiorly, posteriorly, or inferiorly-based. The superiorly-based flap has a robust arterial blood supply but less efficient venous drainage, whereas the opposite is the case with the posteriorly-based flap. We present our results of using a superiorly based PMF flap for reconstruction of defects in the parotid, auricular/mastoid, and cheek regions after resection for squamous cell carcinoma. Of 11 patients, eight had no postoperative complications. The remaining three developed venous congestion of their flaps, in two of whom it led to secondary epidermolysis and limited skin loss. The venous congestion resolved with conservative management, and all flaps remained viable. The PMF flap is an alternative to more complex reconstructive options for skin defects of the auricular, parotid, and cheek regions, and gives a satisfactory cosmetic result.