Use of trapezius myocutaneous flaps in the reconstruction of head and neck defects.

The trapezius myocutaneous flap of skin and muscle has, as its major blood supply, the superficial branch of the transverse cervical vessels, which is used as a pedicle. The flap may include the scapular spine as a viable bone graft for mandibular defects. Anatomic and surgical experiences have verified the feasibility of using this flap. The intended vascular pedicle arises separately from the subclavian artery in 25% of these cases. Surgical results using the flap have been excellent. Above the level of the mandible, the flap may lack adequate length. It has been used with success to repair the tongue, floor of the mouth, pharyngeal wall, and skin surface. It is particularly impressive as a method of repairing mandibular defects.