Lower Trapezius Flap for Reconstruction of Posterior Scalp and Neck Defects after Complex Occipital-Cervical Surgeries

Zenga, Joseph
Sharon, Jeffrey D.
Santiago, Paul
Nussenbaum, Brian
Haughey, Bruce H.
Fox, Ida K.
Myckatyn, Terence M.
Diaz, Jason A.
Chicoine, Michael R.

¹Department of Otolaryngology, Washington University, St. Louis, Missouri, United States
²Department of Neurological Surgery, Washington University, St. Louis, Missouri, United States
³Department of Plastic Surgery, Washington University, St. Louis, Missouri, United States

Address for correspondence Michael R. Chicoine, MD, Department of Neurological Surgery, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8057, St. Louis, MO 63110, United States, [email protected]

received August, 30, 2014

accepted after revision December, 08, 2014

published online May, 22, 2015

Journal of Neurological Surgery Part B : Skull Base 76(5):p 397-408, September 2015. | DOI: 10.1055/s-0034-1544123

Abstract

Objectives

To review the indications, techniques, and outcomes for a series of patients in whom the lower trapezius flaps was used for repair of complex posterior scalp and neck defects after posterior occipital-cervical surgeries.

Design

Retrospective case series.

Setting

Tertiary academic hospital.

Participants

A retrospective review of cases that required complex occipital-cervical repair was performed to identify patients who underwent reconstruction using the lower trapezius flap. Data collected included demographics, clinical presentations, surgical anatomy, operative techniques, and outcomes with review of the pertinent literature.

Outcomes

Nine patients who underwent reconstruction using the lower trapezius flap were identified. Prior surgical interventions included five complex tumor resections, two patients with multiple instrumented cervical spine surgeries, one patient with a craniotomy for attempted extracranial to intracranial arterial bypass for a basilar aneurysm repair, and a posterior occipital-cervical decompression after trauma. During the median follow-up period of 7 months, all nine single-stage reconstructions resulted in successful healing without major surgical complications.

Conclusion

Lower trapezius island flaps provide a reliable option for the reconstruction of complex scalp and neck defects that develop after complex occipital-cervical surgeries.