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WHAT ARE THE FASCIO-CUTANEOUS FLAP USED IN HEAD AND NECK RECONSTRUCTION? WHAT ARE THEIR ADVANTAGES AND DISADVANTAGES?

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FlapsAdvantagesDisadvantages
1. Pectoralis Major
- Pectoral branch of the acrominothoracic artery arising from the first part of the axillary artery.
- External segment (50%) may be supplied by lateral thoracic vessels of 2nd part of axillary artery.
- Sternocostal segment
- Perforating branch of internal mammary.
1. Large
2. Rich Vascular supply
3. Large arc of rotation ~zygomahc arch
4. Versatile : Skin only / muscle paddle with skin / muscle
5. Harvested in supine posterior
6. Donor site Primary closure.
1. Large and Bulky
2. Relatively Immobile
3. Violates female breast.
Latissimus Dorsi Flab
- 1st myocutaneous flab.
-Thoracodorsal vessels -> Subscapular -> Acteytol D
- Venae Commitantes -> axillary vein
-thoracodorsal nerve ( Posterior cord of brachial plesous)
1. Large Amount (10x8 cm)
2. Pedicled/ Free Tissue Transfer
3. Cosmetic advantage in female
4. Versatile tubed
5.when pedicled it can reach upto upper face and scalp.
1. Very Bulky
2. Donor site dehiscense ocassionally
3. Reduction in upper limb power.
4.May require moving the patient to harvest.
Sternomastoid Flap
-2 branches of occipital artery (Upper Half )
- Superior thyroid artery branch in lower half.
- Rarely used.
1. Can be used as componk
skin = muscle flab / muscle = bone flab
2. Split along its length and rotate anterior to cover vessels in compromised vein
1. Poorly vascularized and not reliable
2. Areas of oncological significance
3. Superior reconstructure ophon available.
Ivapezius Flap
- Vascular supply complex and varies with design
Occopital artery and venae comitantes
1. Used for defect of the temporal bone, Lateral face or upper neck
2. Lifeboat / Salvage when other flap fails.
Platysma Flap
Upper Part -> Submental branch of facial artery

Lower Part -> Transverse cervical artery branch
1. Unreliable blood supply
2. Avoid as source of reconstruction of oral cavity
3. May remove blood supply of overlying skin.
4. Area of oncological significance.
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