Surgical education cadaver model video for transoral. Physio for osteoarthritis of the hip upwell health. Conclusions the platysma flap is simple and versatile with properties similar to the radial forearm free flap. Pdf platysma myocutaneous flap its current role in reconstructive. Turnover platysma flaps also correct such a deformity. In selected cases, the flap will extend to the oropharynx. The oral cavity and oropharynx are common locations of neoplastic lesions. First, under edit preferences measurements make sure you are using the right units for your drawings. Vertical platysma myocutaneous flap that sacrifices the facial artery.
The technique was used in 1 patient who had tracheal carcinoma and whose tracheal stump was 1. In addition to surgical measures, such as excision of the affected skin or the interposition of fascia lata, muscle flaps platysma, or silastic sheeting temporary, there are also drug treatments involving the systemic or topical application of anticholinergics or antihydrotics. Since the first report of a platysma transverse myocutaneous flap in 1977, few articles about this flap design have been added to the literature. Muscles of facial expression are involved in social signaling among primates, and are a primary means by which close.
A simple myocutaneous flap for shortstump mediastinal. Postsurgical imaging of the oral cavity and oropharynx. So, we are not far off in terms of lateral commissure movement. I have performed face and neck lifts for over 20 years and imho, you shouldnt get hung up on any one technique. The platysma myocutaneous flap for oral cavity reconstruction. Transoral endoscopic thyroidectomy vestibular approach toetva may represent the next phase of minimally invasive endocrine surgery, and early clinical experience shows that toetva is indeed possible in selected patients. The platysma myocutaneous flap for oral cavity reconstruction kevin h. Jan 26, 2015 the platysma muscle is expansive in size, with a broad width that spans the collarbone, or clavicle, and the side of the neck. Platysma definition of platysma by medical dictionary. Pdf the platysma myocutaneous flap pmf for head and neck. Its flap may be used as superiorly, inferiorly or posteriorly based.
It includes the delicate superficial cervical fascia just deep to skin that envelopes the platysma and muscles of. This reconstruction technique was chosen because of the poor. Role of platysma muscle flap in depressed scars of neck. Four fresh cadaver specimens were injected with microfil flow technologies, inc, carver, me red stain in the common carotid artery and blue stain in the brachiocephalic vein. Now in its third edition, this unsurpassed quality remains and is further enhanced by some useful new material. Flap anatomy, 2011 by dukeunivlibraries, via flickr.
Through the handson process of exposing layer after layer of anatomical illustrations, flap books mimic the act of human dissection, inviting the viewer to participate in a virtual autopsy. Flipviewer xpress is a professional software which is designed to publish and deliver contents in an appealing 100% online pageturning format we call them flipbooks. The flap is oriented in the mandibular cheek region. The posteriorly based platysma flap in oral and facial reconstruction. Better to cut over active platysma band, or tie bands together. When i asked about the location of incisions, he said the incisions are approximately 3cm long in front of ears and behind the ears. The platysma myocutaneous flap dates back to 1887 when an austrian surgeon, robert gersuny, described repair of a cheek defect. The platysma myocutaneous flap oral and maxillofacial surgery. The results of treatment of 36 patients tumour excision plus bilateral neck dissection and post.
Pdf vertical platysma myocutaneous flap reconstruction for. Singlestage reconstruction of hypopharyngoesophageal. The superiorly based platysma myocutaneous flap is a common reconstruction option for intraoral defects followed after excision of fibrous bands in oral submucous fibrosis. Manual crosschecking of their references yielded 3 more articles for a total of 31. This condition can affect the knee, hips, and spine, hands, and other joints. Role of platysma muscle flap in depressed scars of neck rakesh k. The advantages of this flap are the proximity to the surgical area, and the fact that the skin island pedicled by platysma muscle is easily harvested and transplanted to the defect. The platysma myocutaneous flap for intraoral reconstruction was introduced in 1978. Predicting occlusal force and area through a biomechanical. Yet, it was only introduced to the english literature in 1978 by futrell et al, 1 and since then, it has become established as an attractive reconstructive alternative with several potential advantages. Is it possible to calculate dimensions, area and perimeter using pdf xchange. On the lower face, depressor muscles of the lower lip were reinserted on the periosteum of.
Its point of origination is the upper portions of the pectoral, or. Gross and histologic aspects of facial expression muscles are presented here for otolemur spp. Flipviewer xpress turn your pdf to ebook in 10 minutes. Our experience of using a vertical platysma myocutaneous flap in a group of patients who underwent reconstruction after t2staged oral cancer surgical resection associated with neck dissection is. Tissue expansion reconstruction in clinical practice has existed for over half a century. A treatment plan was agreed to that included osseous genioplasty vertical lengthening with interpositional grafting and minimal horizontal advancement and an anterior approach to the soft tissues of the neck cervical flap elevation, neck defatting, and vertical platysma muscle plication. Anatomy next provides anatomy learning tools for students and teachers. The technique was initially used for breast reconstruction but later found its use in reconstruction of excisional defects resulting from a variety of causes including surgery for postburnposttraumatic deformities, congenital giant naevi, skin cancer, etc. The plane of elevation should include the sternocleidomastoid fascia, as.
The api provides developers with a variety of methods and options for integrating the viewer functionality into applications or website pages. Superior sulcus lesions include a constellation of benign or malignant tumors extending to the superior thoracic inlet and causing a steady, severe, and unrelenting shoulder and arm pain along the distribution of the eighth cervical nerve trunk and first and second thoracic nerve trunks, horners syndrome ptosis, miosis, and anhidrosis, and weakness and atrophy of the. First published in 1991, human sectional anatomy set new standards for the quality of cadaver sections and accompanying radiological images. In the lateral face, immediately in front of the ear, extending 2530 mm forward of the ear cartilage to the posterior border of the platysma, is a diffuse area of ligamentous attachment, described by furnas as the platysma auricular fascia paf. It is important that the viewer understand that this is a nonfdaapproved application and this is a decision to be made by the surgeon and a. The platysma myocutaneous flap was introduced for intraoral reconstruction. Osteoarthritis is one the most common forms of arthritis worldwide. Surgical management of superior sulcus tumors dartevelle. The platysma flap has often been used for reconstructions of the head and neck, but the arterial anatomy of the platysma itself has not been clarified.
Metrics such as occlusal pressure and jaw kinematics provide quantitative assessments of masticatory function, facilitating a more comprehensive evaluation of patient. The pectoralis major pedicle flap is vascularized by the thoracoacromial artery and is the most commonly used pedicle flap in the head and neck region 20 fig 7. The lower part of left submandibular salivary gland and left internal jugular vein were cut. Vertical platysma myocutaneous flap that sacrifices the. In the nonpedicled half, the flap comprised skin, subcutaneous mucosa, and platysma muscle. The platysma flap may be used to close defects on the lower face, buccal mucosa, and floor of mouth. The skin and the platysma muscle fibers, which run vertically, are incised and turned 90 degrees, so the edges of the platysma fibers are sutured to the edge of the residual orbicularis. Role of platysma muscle flap in depressed scars of neck original. Evolution of the muscles of facial expression in a. Posttreatment ct and mr imaging in head and neck cancer. A report by the american society of anesthesiologists task force on preanesthesia evaluation you will receive an email whenever this article is corrected, updated, or cited in the literature. Platysma motor nerve transfer for restoring marginal. Our experience in handling the flap may contribute to the success rate. Platysma myocutaneous flap pmf is a generally used technique for defect.
The buccal fat pad is identified and excisedsuspended to create appropriate symmetry to the affected side. Common facial veil is usually obstructing approach to the artery and has to be dissected, clamped, cut, and. If a standard aprontype flap is raised for a neck dissection, the inferior margin of that flap will be the inferior margin of the platysma flap. The platysma flap was first used by gersuny 1887 for reconstruction of a throughandthrough cheek defect. Follow the stepbystep instructions to show how to fold origami models and embellish them with stunning zen doodle patterns. Platysma myocutaneous flap for patch stricturoplasty in. The goal of this surgical treatment is to achieve tumor control while preserving, whenever possible, the function of local structures. Accurate visualization of the surgical field with highresolution video imaging cameras such as the closedcoupled device ccd of the laparoscope can serve to insure clear visual observation of surgery and share the surgical procedure with trainees and, or. All of them were reconstructed with a platysma flap after neck dissection. Blood supply of pectoralis major flap figures 2, 3 the pectoralis major flap is an axial flap and is based primarily on the pectoral branch of the thoracoacromial artery and the thoracoacromial artery is a branch of the axillary artery, itself a continuation of the subclavian artery.
Platysma definition and meaning collins english dictionary. Study smart with student consult elsevier transform the way you learn. Most clinicians have limited personal experience and rely on guidelines. Virtual interactive presence and augmented reality represents an ongoing evolution of remote surgical capability and surgical telecollaboration. Tissue expansion reconstruction of head and neck burn. Health, general cell research cytological research face lifts health aspects patient outcomes research flaps surgery medical research medicine, experimental mouth diseases care and treatment rhytidoplasty surgical flaps. Platysma article about platysma by the free dictionary. Platysma medical definition merriamwebster medical dictionary. Use of versatile platysma flap in oral and maxillofacial surgery. Distance, area and perimeter using pdf xchange cad software.
The pedicle flaps used in the head and neck region are the pectoralis major flap, latissimus dorsi flap, deltopectoral flap, trapezius flap, and platysma flap 18 20. Is it possible platysmaplasty can be done without any incision under the chin. Atlas of muscle and musculocutaneous flaps platysma. Dull weitlaner is the best choice from this group of retractors. Identify the key landmarks in the midline of the neck and their significance state the structures that are situated at the level of c6 outline the boundaries of the triangles of the neck describe the landmarks for palpation of the main arteries, which can be palpated in the. Platysma myotomy is not performed on the unaffected side since the marginal mandibular nerve is not directly isolated.
Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects 5 skin paddle up to the mandible, leaving the platysma down. Ultimate green striped markings visual zygomorphic flower shape upper sepal column fused male and female parts anther cap pollinium pockets of pollen. The platysma is a superficial muscle that overlaps the sternocleidomastoid it is a broad sheet arising from the fascia covering the upper parts of the pectoralis major and deltoid. Modified selective neurectomy with symmetrical facial. The aim of the study is to present our experience using vertical pmf that sacrificed the facial artery and vein for intraoral reconstruction. However, facial proprioception plays a key role in the regulation and coordination of the. Ingestions range from mild cases with no injury to severe cases with full thickness. The subplatysmal flap must be elevated bluntly as it may expose the marginal mandibular nerve. Platysma myocutaneous flap its current role in reconstructive. Butterfly wings, scales and waves on the fish to make a relaxing mobile aquarium, a magical box, a picnic.
Combined submentaltongue flap for reconstruction of subtota. Telepresence has been employed in a variety of surgical applications. There is still some reluctancy to use the flap in view of reported flaprelated. Figures 1, 2ad, 3, 4 and 5 show the form of the platysma muscle and its attachments. This study evaluated the blood supply of the superiorly based and posteriorly based platysma muscle myocutaneous flap. Dherde thesis submitted in fulfillment of the requirements for the degree of doctor in medical sciences department of basic medical sciences faculty of medicine and health sciences 2015. It is a random flap comprising skin, subcutaneous fat, superficial neck veins, and platysma muscle. Platysma myocutaneous flap for oral cavity reconstruction. Additionally, you can customize the snapping settings to snap to grid, guides and objects.
The superiorly based flap has an excellent blood supply, but less efficient venous drainage when compared with posteriorly based flap. When i searched on the internet, it looks like most doctors will have an incision under chin when doing platysmaplasty surgery. Extended nasolabial flap compared with the platysma myocutaneous muscle flap for re construction of intraoral defects after release of oral submucous fibrosis. The advantages of platysma flap include good color match, easy access to the donor site in the same operative field with minimum morbidity of donor site, ease. The pedicle flaps used in the head and neck region are the pectoralis major flap, latissimus dorsi flap, deltopectoral flap, trapezius flap, and platysma flap 1820.
Pdf platysma myocutaneous flap its current role in. True labiaplasty is then presented to give the viewer an introduction to the rationale and performance of this technique. The facial muscles are innervated by efferent motor nerve fibers and typically lack proprioceptors. With the pinch test, the width of the flap was determined, and the flap was elevated from the opposite side toward the pedicle. Platysma muscle cutaneous flap for large defects of the. This flap receives its blood supply primarily from branches of the a. Connections between the facial and trigeminal nerves. Image quality evaluation in xray medical imaging based on.
Platysma myocutaneous flap can be accomplished in a single stage owning many advantages in comparison with other flaps for patch stricturoplasty in relieving the short and benign cervical esophageal stricture ie, it is closer to the recipient site, thinner, pliable, and reliable. Digital video capture and synchronous consultation in open. A comparative morphological study of two human facial. Currently, most evaluations of patient outcome following mandibular reconstructive surgery are defined by a combination of qualitative analyses consisting of patientreported functional ability and masticatory performance. In 1951, edgerton described a lateral cervical island flap based on the platysma muscle for reconstruction of intraoral defects.
Angiographic study of the platysma, abstract background. Useful for grade 4 trismus, in defects involving large areas of cheek lining and adjoining areas like the palate. The arc of rotation is suitable for reconstruction of the lower lip, floor of mouth, ventral tongue, and lower one third of the face. While silicone is not approved by the fda, it can be sued safely in a very minor touchup fashion as described by dr. The platysma myocutaneous flap pmf was first used for intraoral.
Platysma myocutaneous flap for reconstruction of intraoral. A long, ushaped myocutaneous flap was designed to construct mediastinal tracheostomy in patients with a short tracheal stump. Corrosive ingestion is a rare but potentially devastating event and, despite the availability of effective preventive public health strategies, injuries continue to occur. All of the authors have read and approved the final manuscript. Slift is a procedure where the soft tissue smas and platysma is plicated like a purse string.
It was hypothesized that human facial muscles sharing the same innervation and embryology, but having different functions, would posses morphologic differences in architecture, histology, cytochemistry and ultrastructure. Herein, we investigate the anatomical technical feasibility of transfer of the platysma motor nerve pmn to the mmn for restoration of lower lip function, and we present a clinical case where this nerve transfer was successfully performed. The pectoralis major pedicle flap is vascularized by the thoracoacromial artery and is the most commonly used pedicle flap in the head and neck region. Platysma myocutaneous flap is easy to harvest, thin and pliable, promoting threedimensional reconstruction, and there is a limited donor site morbidity with primary closure of the neck. Platysma myocutaneous flap its current role in reconstructive surgery of oral soft tissue defects. It is ideal for presenting digital materials online or offline. Jul 24, 20 platysma myocutaneous flap pmf is a generally used technique for defect reconstruction after an oral cancer resection.
The mucosal layer and the vermilion are reconstructed with a rotational flap from the cheek mucosa. The flowpaper web pdf viewer api enhances the viewing and publishing of onlinecontent such as brochures, catalogs, and magazines. Maxillofacial surgeon an overview sciencedirect topics. Original article, report by ear, nose and throat journal.
The platysma myocutaneous flap pmf is a common reconstructive option for defects in the head and neck region. Other readers will always be interested in your opinion of the books youve read. Dull weitlaner, beckman retractor, or gelpi retractor is placed for wound exposure. In surgery, this occurs more frequently, for example, when a certain geometric design of a flap of tissue is modified and utilized in a fashion that may not correspond exactly to the way it originally was described or designed. The rate of complications is similar to other published series, and problems encountered were manageable using conservative methods with excellent functional and cosmetic outcomes. A tube was formed in the lower part of the flap, and this was used to reconstruct the excised stenosed segment of the esophagus while the postcricoid defect was closed, using the upper part of the flap in continuity as a trapdoor by stitching the skin edges to the openedout edges of the stenosed segment. Feb 21, 20 the outline of the platysma flap is initially made as an ellipse with the inferior margin low in the neck above the clavicle.
In this regard, statistical analysis of our results indicated the validity of using the pt, mp distances as well as the epiglottis excursion angle. Desprez and kiehn 1959 reported the modified apron flap, which included the platysma muscle. The perfusion of the abdominal flap is maintained thus avoiding necrosis and reducing wound complications. This article presents two versions of the platysma myocutaneous flap, which is a reliable, axial pattern, pedicled flap capable of providing. The contour of the skin flap was designed very precisely in accord with a rigid metallic pattern manufactured on the recipient to match exactly with the dimensions and shape of the injury. Virtual interactive presence and augmented reality vipar. For the evaluation of the phonoarticulatory tract with dynamic mr it is necessary to identify a anatomical reference parameters. The outline of the platysma flap is initially made as an ellipse with the inferior margin low in the neck above the clavicle. The platysma muscle is a muscle that runs from the upper chest and shoulders, up through the neck, and attaches to various parts of the lower face. The commissure to midline distance is 30 mm compared with 32 mm on the opposite side. Oct 28, 2017 a reliable regional flap based on perforators.
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