Osteochondromas are benign bony tumors which are commonly believed to originate by the proliferation of epiphyseal cartilage into the surrounding tissues. However, this hypothesis cannot explain the occurrence of this tumor in the intramembranous bones and soft tissue. Since most of the craniofacial bones have intramembranous origin, the occurrence of this lesion in this territory is considered rare. Contrary to the above hypothesis, Lichtenstein proposed that this entity arises from the metaplastic changes in the periosteum which explains the occurrence of this tumor in endochondral as well as intramembranous bones and also in soft tissues. Complying with Lichtenstein's hypothesis, the authors are presenting two cases of osteochondromas with one arising from the endochondral bone (the coronoid process of the mandible) and the other from an intramembranous bone (lateral pterygoid plate of the sphenoid).
Introduction
High lateral and posteriorly based defects are challenging to reconstruct as mobilization of conventional pedicled flaps is difficult. This study was done to evaluate the usefulness of lower trapezius myocutaneous flap (LTMC) in selected cases as a reconstructive alternative to other pedicled flaps which have positional and technical disadvantages and/or in cases where free flap is not possible.
Materials and Methods
Ten cases of locally advanced (T3 and T4) high and laterally placed head and neck carcinoma (8 cases of SCC involving posterior scalp, ear lobule, skin anterior to tragus and 2 cases of locally advanced salivary gland malignancies involving parotid glands) irrespective of sex had been selected. Due to non-availability of plastic surgeon in the institute none of the patient could be subjected to free flap reconstruction. All the patients received post operative adjuvant radiotherapy and were followed up on a monthly basis for six months at least.
Results
Out of total 10 cases 5 underwent wound infection and dehiscence at recipient site. In 3 cases there were donor site seroma. In 2 cases healing was uneventful. However in all cases the flap was healthy and flap survival was 100%. There was no flap contracture in long term follow up.
Conclusion
The LTMC flap is ideal for mentioned defects because of its anatomical location, abundant blood flow, minor donor-site morbidity, and long pedicle. The LTMC flap, though less commonly used, is a precious option in situations where free flaps and other pedicled flaps are not feasible.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.