Indications

The most useful of the three flaps is the superior trapezius flap. Although this is not a first-line flap, it is extremely hardy and can be used after radical neck dissection. It provides coverage for difficult wounds including persistent orocutaneous fistulas and exposed carotid arteries (Figs. 13, 14). -g

The lateral and lower island trapezius flaps provide thin pliable tissue for reconstruction of almost any defect in the ipsilateral head and neck (Figs. 15, 16). ยป

The lower island flap is most often used for lateral skull base defects since the patient can be placed in the lateral decubitus position for both recipient site extirpation and d flap harvest (Figs. 17, 18). >3

The anatomy of the vascular pedicle in the posterior triangle of the neck is extremely variable, and the artery or, more commonly, the vein will pass under the scalenes or brachial plexus. This limits the mobility of the vascular pedicle, thus severely limiting the use of the lateral island flap.

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