Modification of Cervicofacial Flap for Moderate to Major Facial Defect

Abstract

The original Cervicofacial flap is subcutaneous flap which has been used for large cheek defect for more than 30 years. The color and texture of this flap are suitable for the reconstruction and also the donor site is hidden. The most common complication flap conventional Cervicofacial flap is Tip or Partial necrosis of flap. Deep plane Cervicofacial flap has been developed to avoid this necrosis. The Platysma muscle is including in all area of Deep plane Cervicofacial flap so the blood supply is augmented. However, the most complications of Deep plane Cervicofacial flap are injury to the Facial nerve branch and ectropian of lower eyelid.

This paper reports the modification of the Cervicofacial flap to avoid Tip or Partial necrosis of conventional Cervicofacial flap and avoid the complication in the Deep plane Cervicofacial flap (Facial nerve branch injury and ectropian of lower eyelid). The modified technique of Cervicofacial flap in this report had been operated in 32 patients at Hatyai hospital for 20 years (1989-2009). There was no complication of Tip necrosis of flap and Facial nerve injury. However, three patients had minor complications, one had mild degree of ectropian of lower eyelid, one had Dog ear (they were corrected by surgery under local anesthesia) and the last one had a small defect of donor site (it was treated by skin graft).