PP148

Introduction The trapezius myocutaneous flap is an effective alternative to microsurgical techniques for reconstruction of surgical defects after oncological resection in oral cavity. The extraction technique is simple, being a predictively viable flap. It may be harvested as an osteomyocutaneous flap and can even be used to reconstruct the mandible. As a main drawback, highlights the need for change in posture of the patient during surgery, which stretches, although not overly, the operative time. We present a series of patients operated in our Department, in which we used the trapezius flap for the reconstruction of surgical defects in the head and neck. Materials and methods Nine cases are included in our study. In eight of them the flap was designed as a myocutaneous flap, while in the last patient it was an osteomyocutaneous flap, incorporating the spine of the scapula to reconstruct a segmental mandibular defect created after a tumor excision. Seven cases were oncologic surgical defects (squamous cell carcinomas of the tongue, jaw, retromolar trigone, tonsillar fossa and soft palate). The other two cases were used to temporal fossa reconstruction after a titanium mesh that were used in a previous reconstructive attempt, were removed because of its exposure with a soft tissue defect. The mean time to harvest of the flap was 65 min. Results One patient died of locoregional recurrence of the tumor at 6 months after surgery and another two patients had a flap necrosis by compression of the pedicle. MMSS mobility was recovered in all cases after rehabilitation and physiotherapy. In two cases, surgical wound dehiscence occurred at the back, resolved without the need for skin grafting. Conclusions While at present microsurgical flaps are the first choice for the reconstruction of head and neck cancer defects, regional flaps as the trapezius or pectoralis remain a valid and effective weapon when free flaps can not be considered for some reasons, attributable to the patient or to structural problems in the Surgery Departments. The myocutaneous or osteomyocutaneous trapezius flap is easy to manage, with a constant vascular pedicle. No major complications have been found postoperatively.