[Vertical trapezius myocutaneous flap for repairing soft tissue defect after head and neck tumor resection].

OBJECTIVE: To introduce the experience of the clinical application of vertical trapezius myocutaneous flap in repairing soft tissue defects after head and neck tumor resection.

METHODS: Between June 2008 and February 2010, 12 cases of soft tissue defect caused by head and neck tumor resection were repaired with vertical trapezius myocutaneous flap. There were 9 males and 3 females with an age range from 32 to 76 years (median, 54 years). Twelve cases including 2 cases of basal cell carcinoma of orbital skin, 2 cases of squamous cell carcinoma of the parotid gland, 2 cases of submandibular gland malignant mixed tumor, 2 cases of metastatic lymph nodes of nasopharyngea carcinoma after radiotherapy, 1 case of squamous cell carcinoma of tongue, and 3 cases of squamous cell carcinoma of occipital skin, and all were classified as TNM stages T3 or T4. The area of soft tissue defect ranged from 13 cm x 6 cm to 25 cm x 13 cm. The vertical trapezius myocutaneous flap ranged from 14 cm x 7 cm to 26 cm x 14 cm and was transferred to repair defect tissue in the homolateral wounds after tumor resection and neck dissection homochronously. The donor sites were sutured directly.

RESULTS: All incisions healed primarily without infection. Eleven flaps survived except 1 flap with edge necrosis, which was cured after dressing change. Subcutaneous hematocele and effusion occurred in 2 cases on the back after tube was removed at 7 days postoperatively, and they were cured by sucked and pressured dressing. Eleven patients were followed/up 1-3 years (mean, 2 years). Nine cases had no tumor recurrence and the flaps had satisfactory appearance; the abduction function of shoulder joint were normal. One case of orbit basal cell carcinoma occurred 3 months after operation and 1 case of nasopharyngeal carcinoma died of brain metastasis 12 months after operation.

CONCLUSION: It is an easy and simple therapy to repair head and neck soft tissue defect using the vertical trapezius myocutaneous flap, which can meet the needs of repairing tissue defect of head and neck.