Platysma Myocutaneous Flap for Skull Base Reconstruction: A Cadaveric Feasibility Study

Ear Nose Throat J. 2024 Dec 4:1455613241304283. doi: 10.1177/01455613241304283. Online ahead of print.

Abstract

Objective: As skull base defects become increasingly complex, necessitating more extensive repairs, alternative strategies are needed to address challenging reconstructions and rescue cases of failed primary reconstruction. In this study, we aimed to validate the surgical technique and assess the feasibility of using the platysma myocutaneous flap for skull base reconstruction, using cadaveric specimens in a preclinical setting. Materials and Methods: This descriptive anatomical study was conducted on 2 fresh human cadavers (4 sides). The study assessed the flap's size, range of rotation, suitability for covering the skull base, and the corridor technique for transferring the flap to the skull base. Results: The technique was applied to 2 cadavers, with 4 flaps raised. The average flap length was approximately 15 cm, providing adequate coverage of the ipsilateral carotid artery and anterior skull base, extending from the planum sphenoidale to the cribriform plate and frontal recess. Conclusion: Harvesting a platysma myocutaneous flap is a feasible option for skull base reconstruction, providing adequate coverage for the ipsilateral carotid artery and anterior skull base.

Keywords: cerebrospinal fluid leak; endonasal endoscopic approaches; platysma flap; skull base reconstruction.