Issue N# 3 - 2009
Study of the platysma coli muscle vascularisation by the facial artery. Implication during the elevation of the musculo-cutaneous plastyma coli muscle flap
Authors : Cartier C, Jouzdani E, Garrel R, Makeieff M, Crampette L, Guerrier B. (Montpellier)
Ref. : Rev Laryngol Otol Rhinol. 2009;130,3:139-144.
Article published in french
Downloadable PDF document french
Aim of the study: The purpose of this study was to assess the vascularity of the platysma muscle by the branches of the facial artery, in order to determine the best means of harvesting a musculo-cutaneous flap while ensuring maximum vascular security. Patients and methods: Ten platysma muscles were dissected on 4 fresh specimens and one formaldehyde-preserved specimen. The dissection was performed after injection of the facial artery in 6 cases, while 4 muscles were dissected without any previous injection. Results: The vascular supply of the platysma muscle comes essentially from the branches of the sub-mental artery and from branches descending straight from the facial artery. Other collateral branches contribute to this vascularization, but their importance is minor. All these arteries reach the muscle, entering its visceral aspect, then proceed to the sternal notch in a radial axis. Conclusion: The size of the flap has to be defined within a quadrilateral figure with its base formed by the mandibular edge and its apex by the inferior limit of the flap. It is essential to preserve the maximum possible muscular thickness, especially on the medial side of the flap. If the facial artery needs to be ligated, this has to be done as it enters the submandibular space in order to protect most of the collateral branches destined to the muscle. The vascularization is then taken back by the homo- and contro-lateral facial vascularisation in an inverted flow in the remaining segment of the facial artery.
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