The Cervicofacial Flap in Cheek Reconstruction: A Guide for Flap Design

Shetawi, Al Haitham Al; Quimby, Anastasiya; Fernandes, Rui

doi:10.1016/j.joms.2017.08.006

Cited by 18 publications

(15 citation statements)

References 12 publications

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“…Among reconstructive procedures for defects following head and neck cancer resection [1,2], loco-regional rotation flaps are still a widely accepted solution due to their excellent skin color and texture match, decreased morbidity at the donor site and reduced surgical risks [3,4]. In this regard, cervicofacial and cervicothoracic flaps have all advantages of smaller local flaps, but they are also suitable option after excision of advanced malignancies [10][11][12][13]. Conley described cervical and thoracic rotation flaps to reconstruct wounds of the lateral neck and face [14].…”

Section: Discussionmentioning

confidence: 99%

“…The cervicofacial flap, an extended version of Mustarde's rotation flap [9], has been described for the reconstruction of midface soft tissue defects especially on cheek, temple and inferior eyelid [1][2][3][4][5][6][7][8][9][10][11][12]. Its cervicothoracic variant includes the dissection of the superior thoracic wall to expand the arc of rotation [13].…”

Section: Introductionmentioning

confidence: 99%

“…Its cervicothoracic variant includes the dissection of the superior thoracic wall to expand the arc of rotation [13]. Cervicofacial and cervicothoracic flaps are timesaving flaps that provide excellent skin color, thickness and texture match with cosmetically acceptable scars and minimal donor site morbidity [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Use of cervicothoracic rotation flap and osteocutaneous radial forearm free flap for a complex multilayered cheek defect reconstruction

Tankersley

Martinez

Medina

2020

Case Reports in Plastic Surgery and Hand Surgery

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Use of cervicothoracic rotation flap and osteocutaneous radial forearm free flap for a complex multilayered cheek defect reconstruction

Tankersley

Martinez

Medina

2020

Case Reports in Plastic Surgery and Hand Surgery

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“…Zone 1 refers to suborbital defects, Zone 2 includes defects in preauricular/temporal areas, and Zone 3 is the perioral, lower cheek and lateral mandibular region. A straightforward algorithm for this flap design was recently published by Al Shetawi et al in a series of cases [7].…”

Section: Discussionmentioning

confidence: 99%

Modified Cervicofacial Flap for Large Cheek Defect Reconstruction under Local Anesthesia

Sharma

Nigam²

2019

Case Reports in Surgery

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The cervicofacial flap was first described in 1969. For the past several years, it has been the flap of choice for the reconstruction of facial defects especially cheek defects. In recent years, with the advent of microvascular free flap tissue transfer, the use of a cervicofacial flap has been sparse. This article highlights the importance and application of locoregional flaps such as a cervicofacial flap in the reconstruction of soft tissue defects on a face. This case was unique from the reconstruction point of view. An 81-year-old patient presented to us with a long standing ulcerated growth in his left cheek which was neglected due to lack of symptoms and his poor financial condition. Clinically, the extent was defined from the suborbital skin region till the mid cheek region and medially from the lateral nasal crease up to the cheek prominence area. An initial biopsy suggested basal cell carcinoma. The lesion was excised, and a 4.5×5.5 cm defect was reconstructed using a modified “cervicofacial” flap under local anesthesia. Our experience shows that this technique is a reliable, easy to harvest flap with good outcomes. Moreover, it can be utilized in those candidates not suitable for a free flap procedure under general anesthesia.

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“…In one of these modifications, Schrudde described an angle-rotation flap, which extended the flap design behind the ear at a sixtyto-ninety-degree angle, mobilising retroauricular tissues for better coverage [19]. For coverage of more medially located defects, modifying this flap design by extending incision from retroauricular to upper cervical tissues with a curved incision (as a back-cut), rectified this problem [20]. In this series, incision lines followed that for extended facelift surgery, with low retroauricular extension and incorporating lateral upper neck tissues if necessary (Figures 1b, 2c & 3d).…”

Section: Case 3 (Case Id 10)mentioning

confidence: 99%

Augmented facelift flap for aesthetic reconstruction of posttraumatic facial defects

Saha¹

2020

J Med sci Res

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introduction: Reconstructing posttraumatic facial defects to achieve aesthetically pleasing results is challenging. Different flaps, including many modifications of cheek flaps, are commonly performed, but several problems persist. aim: To evaluate the effectiveness of an augmented facelift flap for reconstructing posttraumatic facial defects. Fundamentally a rotation-advancement flap inspired by extended facelift markings and deep-plane facelift dissection, it incorporates retroauricular and cervical tissues whenever necessary. Materials and methods: Ten patients (eight males, two females) with cheek, lateral orbit, and lower eyelid defects were reconstructed with augmented facelift flaps between January 2009 and December 2019. Size of defects ranged between 10.5 to 27 cm 2 , and patients age between 21 to 78 years (mean, 49.3). Deep-plane facelift dissection was performed for extensive facial defects and subcutaneous dissection for smaller ones. Flap design was based on the principles of extended facelift surgery with necessary extensions. Meticulous dissection and anchoring 'key sutures' in four different facial regions were vital in preventing complications. results: Augmented facelift flap aptly reconstructed defects over the medial cheek, lateral orbit, and lower eyelid with aesthetically pleasing results. Nine patients (90%) healed well without any long-term complications. Among short-term complications, superficial necrosis was found in one patient (10%) and mild venous stasis in three patients (30%). Flap loss and infection were absent. Lower eyelid ectropion and deep marginal necrosis occurred in one patient (10%). Overall, patient satisfaction scores ranged between 50-90 percent (mean, 78%). Conclusion: Augmented facelift flap successfully reconstructed posttraumatic facial defects over the cheek, lateral orbit, and lower eyelids with satisfying aesthetic results.

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The Cervicofacial Flap in Cheek Reconstruction: A Guide for Flap Design

Cited by 18 publications

References 12 publications

Use of cervicothoracic rotation flap and osteocutaneous radial forearm free flap for a complex multilayered cheek defect reconstruction

Use of cervicothoracic rotation flap and osteocutaneous radial forearm free flap for a complex multilayered cheek defect reconstruction

Modified Cervicofacial Flap for Large Cheek Defect Reconstruction under Local Anesthesia

Augmented facelift flap for aesthetic reconstruction of posttraumatic facial defects

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