Trapezius myocutaneous flap in reconstructive surgery for head and neck cancer: An original technique

Demergasso, F D; Piazza, Mario

doi:10.1016/0002-9610(79)90414-8

Cited by 181 publications

(44 citation statements)

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“…The average dimensions of the perforasome were 6.6x7.06cm, corresponding to a mean area of 36.6 cm 2 (range, 20-90). The transmuscular pedicle had an average length of 12.13cm (range, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. More than 80% of the perforators that we found were musculocutaneous.…”

Section: Resultsmentioning

confidence: 99%

“…14 This flap was initially described by Demergasso et al 15 It differs from the pedicled flap of the lower trapezius, which uses the portion of the muscle below the spine of the scapula. This last flap cannot contain any bone, and its vascularization depends on the transverse artery of the neck and the dorsal scapularis artery.…”

Section: Discussionmentioning

confidence: 99%

“…Variations in the path of the 2 main arteries of trapezius flaps (the transverse artery of the neck which runs deeply and gives branches for the middle part of the trapezius, and the dorsal scapularartery) have been studied by Huelke. 16 The first description of the trapezius flap by Demergasso et al 15 had already exposed the particular difficulties of this technique: the removal of the bone which must respect the acromion, the anatomical variations of the venous drainage and the impossibility of taking the accessory nerve for thick flaps. Concerning this last point, Vacher et al…”

Section: Discussionmentioning

confidence: 99%

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Morphological Anatomy of the Trapezius Muscle, about 58 Dissections: What to Know before Harvesting the Muscular Flap

Nyemb¹

2017

MOJAP

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Introduction: The musculocutaneous flaps of the trapezius muscle are interesting options in head and neck reconstruction surgery. However, these flaps are based on a very variable vascularization of the trapezius. The purpose of this paper is to review the basics of the trapezius muscle morphology and vascular anatomy, through a series of dissections. Materials and methods:Fifty-eight anatomical regions were dissected. For each dissection the perforating arteries of the trapezius muscle have been identified and the morphological anatomy of the muscle has been studied. Results:In all our dissections, the trapezius muscle parts presented as described in the literature: a descending cranial part, a transverse middle part, and an ascending caudal part. On the surface corresponding to trapezius muscle, an average of 15 perforators arteries were found on each side of the line of spinous processes. Conclusion:Each of the trapezius muscle parts can serve as a basis for harvesting a muscular or musculocutaneous flap. However, variations in the vascular anatomy of each part must be taken into account.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Morphological Anatomy of the Trapezius Muscle, about 58 Dissections: What to Know before Harvesting the Muscular Flap

Nyemb¹

2017

MOJAP

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“…El músculo trapecio puede transportar un segmento de hueso, transformándose en un colgajo osteomusculocutáneo, u osteomuscular, bondades que el resto no ofrece 4,7,10,11,15,17,23,41 . La porción de escápula en la que se inserta el trapecio (acromion y espina) está irrigada por vasos musculares.…”

Section: Discussionunclassified

Colgajos pediculados. Una alternativa no descartable en grandes defectos de la cabeza y el cuello

Simkin¹,

Aguilar²,

Rubino³

et al. 2017

Rev Argent Cirug

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Colgajos pediculados. Una alternativa no descartable en grandes defectos de la cabeza y el cuelloPedicled flaps. An alternative worth to be considered for large defects of the head and neck Antecedentes: la cirugía de cabeza y cuello requiere la reconstrucción de los defectos que crea la resección de lesiones neoplásicas de dicha área. Para ello, se necesita el aporte de tejidos vecinos o tomados a distancia. Los colgajos libres cumplen a la perfección con tales principios. Sin embargo, los colgajos pediculados podrían suplir en gran medida las falencias que la aparatología y el personal entrenado ocasionan en un servicio de la especialidad. Objetivo: analizar la aplicabilidad, las ventajas y complicaciones de los colgajos pediculados, sin que signifiquen la primera opción cuando hay que reconstruir un paciente. Resultados: los colgajos pediculados resultaron muy nobles en su aplicación tanto como cobertura como para reconstruir distintos sitios de la vía aerodigestiva superior. Solo se requirió una técnica depurada y la atenta preservación de su pedículo arteriovenoso. En general, se les reconocen ventajas y desventajas a todos. Sobresale entre ellos, el de trapecio lateral por la implícita posibilidad de incorporar hueso. La mayoría reveló reducida curva de aprendizaje, tiempo operatorio comparado con el de los colgajos libres y baja tasa de complicaciones. Conclusiones: los colgajos pediculados no son cosa del pasado. En todos los servicios que no cuenten con un microcirujano entrenado, los colgajos pediculados deben formar parte del menú de opciones reconstructivas en la cirugía de cabeza y cuello. 161-166. http://dx.doi.org/10.25132/raac.v109.n4.1307 RESUMEN ABSTRACTBackground: head and neck surgery requires reconstruction of defects after resection of neoplastic lesions. Although free flaps from close or distant locations may largely satisfy this need, pedicled flaps could replace the lack of aparatology and trained personnel in a specilized unit. Objective: to analyze applicability, advantages and complications of pedicled flaps. Results: pedicled flaps resulted a good option for coverage or reconstruction of different areas of the aerodigestive tract. A neat technique and a careful preservation of the arteriovenous pedicle were required. Although all of the pedicles used have advantages and disadvantages, the best of them resulted the lateral trapezius flap for it allows the association of bone to the flap. All pedicled flaps showed shorter learning curve , operative time and lower complication rate as compared to free flaps. Conclusions: pedicled flaps should not be considered a past issue. Any head and neck surgery unit without a trained microsurgeon should include pedicled flaps as an option for reconstructive procedures.

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“…In Type c, which appears with a high incidence among whites and negroes, Rs and Rp arise independently, which means that Tc does not exist as a common trunk folined both of these arteries, hence various names have been given to these two arteries. Numerous researchers have termed Rs as the super- 1,12,13,28,29,34,44,46) ficial cervical artery ,ascending ramus,7) ascending branch,13) transverse cervical artery,17' 18) and superficial transverse cervical artery, 14,23) and Rp as the transverse cervical artery,1, 12, 13, 29, 34) descending ramus,7) descending branch,13) posterior scapular artery,7' 14' 44) dorsal scapular artery,17' 18) and descending scapular artery.46) Furthermore, the independent Rs branch to the upper portion of the trapezius muscle, which we tetnied the upper superficial branch, has been described as the A. cervicalis superficialis accessoria46) and the superficial cervical artery,13' 44) similar to the name used for Rs. Various researchers have been using the same name (transverse cervical artery, etc.)…”

Section: Discussionmentioning

confidence: 99%

Study on the Subclavian Artery and its Branches in Japanese Adults

Takafuji

Sato

1991

Okajimas Folia Anatomica Japonica

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Summary: We examined the entire array of branches and the state of ramification of each branch of 144 subclavian arteries (Su) in 72 Japanese adults, and obtained the following findings.(1) The incidence of Type I -A(1) was 13.2%, the highest among the entire Su ramification. This was followed by Type I -B(1) at 9.0%, then Type I -A(2) at 6.9%, indicating considerable variation in the morphology of Su ramification. (2) Ontogenetic factors were implicated because of the existence of cases in which Su traversed the scalenus anterior muscle anteriorly (Type III : 0.7%), or was transfixed (0.7%). (3) Type 1-c was the form of thyrocervical trunk (Tic) observed with the highest incidence of 31.3%. In addition, inferior thyroid artery, and those in which another branch was included in this common trunk: 88.9%) be called Ttc.(4) The most common type of transverse cervical artery (Tc), which is formed from a common trunk consisting of highest incidence of 61.8%. Some of the superficial branches to the upper portion of the trapezius muscle that were independently from Su. We concluded that the sites at which Tc and Ss originate are the positions at which they traverse the brachial plexus (superior, transfixed to the plexus). (6) In cases in which the supreme intercostal artery (Is) and the deep cervical artery (Cp) were separate, (Types d-i excluding Type g: 31.9%), Is branched from a more proximal position than Cp.Formation of the human subclavian artery to an almost adult condition occurs in about 7 weeks of embryonic development.5, 6, 10, 26) There have been numerous reports of substantial individual and racial differences in the position of arterial branches and the nature of their ramifications as a result of various factors that have an influence on morphosis.7, 12, 13, 17, 21, 27, 29, 33, 35, 44) However, there are almost no reports of studies that have attempted to characterize and classify the ramification and positions of the entire array of branches arising from the subclavian artery. The only relevant reports in Japan were those by Adachi (28)1) and Ouchi ('63)3°), who described the subclavian artery ramification in Japanese adults, and that by Mori (P41)28), who described Japanese fetuses. However, these reports did not explain the entire subclavian artery ramification, nor determined the most common type of ramification or its incidence among the Japanese population.With recent increase in the use of CT, MRI and angiography, it has been pointed out that an accurate understanding of the morphology of the normal subclavian artery32) and detailed information about the ramification and course of arteries that branch from the subclavian artery12. 22) are essential prerequisites for accurate diagnosis by these techniques of pathogenic changes in the upper limbs. Furthermore, sternocleidomastoid muscle and trapezius muscle are frequently used as a musculocutaneous flap in reconstructive surgery, but despite the fact that the nutrient artery which supplies these muscles is a branch of the subclavian artery, reports ...

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Trapezius myocutaneous flap in reconstructive surgery for head and neck cancer: An original technique

Cited by 181 publications

References 0 publications

Morphological Anatomy of the Trapezius Muscle, about 58 Dissections: What to Know before Harvesting the Muscular Flap

Morphological Anatomy of the Trapezius Muscle, about 58 Dissections: What to Know before Harvesting the Muscular Flap

Colgajos pediculados. Una alternativa no descartable en grandes defectos de la cabeza y el cuello

Study on the Subclavian Artery and its Branches in Japanese Adults

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