Complications of the myocutaneous platysma flap in intraoral reconstruction.

Background: Pedicled myocutaneous flaps remain important tools in head and neck reconstruction. Evaluation of their complications are necessary to judge their merits.

Methods: From 1985 to 1995, 44 patients underwent a myocutaneous platysma flap reconstruction of the oral cavity or oropharynx. The following potential risk factors for complications were analyzed: age, sex, site of primary tumor, TNM stage, previous treatment, neoadjuvant chemotherapy, and type of operation.

Results: Flap-related complications occurred in 18 patients. Only one patient required reoperation for flap failure. Nineteen minor complications occurred in 17 patients. A significant increase in complications was seen in patients in which neoadjuvant chemotherapy was given.

Conclusions: One flap failure was observed in our series. As the platysma flap has several advantages, it should be considered in the reconstruction of small intraoral defects. Contraindications are previous radiotherapy and surgery in the head and neck, neoadjuvant chemotherapy, nodal disease, and large defects.