Treatment of the defect in the occipital region with the myocutaneous trapezius island flap. Clinical case

Abstract

IMSP Institute of Emergency Medicine, Plastic Surgery and Reconstructive Microsurgery Clinic, USMF “Nicolae Testemiţanu” Chişinău, Republic of Moldova, Congresul consacrat aniversării a 75-a de la fondarea Universității de Stat de Medicină și Farmacie „Nicolae Testemițanu” din Republica Moldova, Ziua internațională a științei pentru pace și dezvoltareIntroduction There are three distinct musculocutaneous flaps that can be harvested from the trapezius muscle, making it unique among the regional muscle flaps that are used in head and neck reconstruction. It is divided into 3 parts according to function and the direction of the muscle fibers: superior (descending), middle (transverse), inferior (ascending). Purpose Covering the massive defect in the occipital region with the trapezius inferior myocutaneous flap, avoiding cancer recurrence and forming an aesthetic appearance Material and methods Patient A65-year-old woman who was diagnosed with cornified pluristrative squamos cancer with bone destruction and invasion to confluence sinus and left transverse venous sinus. We cover the defect 10 by 18 cm, that was produced by excision of the occipital extraintracranial tumor removal, thus requiring a more complex approach. We decide to cover the defect with the trapezius inferior myocutaneous flap. Results The defect was completely covered, the donor region being closed in one stage. More than 2 months after the intervention, there was a good integration of the flap, without a recurrence of the cancer. Conclusions The decision of the reconstructive technique should be taken into account with regarding to its consequences on the affected anatomical structures, the personal pathological antecedents and pre-existing lesions at the level of the donor area