The lower trapezius myocutaneous flap for head and neck reconstruction.

The lower trapezius myocutaneous flap has proved to be another useful adjunct in the reconstructive armamentarium of the head and neck surgeon. The flap is based on the descending branch of the transverse cervical artery and vein. Providing these structures are protected during neck dissection, this flap may well become the first consideration of flaps for reconstruction of extensive defects of the head and neck. The flap is safe, reliable, and easy to raise, with constant vascular anatomy. The donor site functional deficit is minimal and the donor site may be closed by direct closure without the necessity of skin graft. Its cutaneous reach and arc of rotation make it a suitable source for skin and muscle replacement for the entire neck, face, and occipital region of the scalp and oral cavity.