OBJECTIVE: To evaluate the effectiveness of nasolabial flap (NLF), a buccal pad of fat flap (BFP), and platysma myocutaneous flap (PMF) for reconstruction following fibrotomy for individuals with oral submucous fibrosis (OSMF).
METHODS: A retrospective study was conducted among patients diagnosed with grade III and IV OSMF in the Department of Oral and Maxillofacial Surgery at Sharad Pawar Dental College between January 2016 and August 2018. The essential patient information was obtained from the Medical Record Department (MRD) at Acharya Vinoba Bhave Rural Hospital (AVBRH), Datta Meghe Institute of Medical Sciences (DMIMS) Sawangi (Meghe) Wardha. The patients were categorized into three groups: the NLF, the BFP, and the PMF groups. Each group had 16 patients, and factors such as interincisal width, diminished burning sensation in the mouth, inter-commissure distance, and flap necrosis were compared pre- and post-operatively. Student\'s unpaired t-test and chi-square test were employed for statistical analysis.
RESULTS: Mean interincisal mouth-opening increased from pre-operative 4.79 to 41.42 mm post-operatively in the NLF group, BFP group from 6 to 39.42 mm and in the PMF group from 9.26 to 39.34 mm with p value=0.0001. NLF group showed complete and partial resolution of the burning sensation of the mouth at 93.75% and 6.25%, BFP at 62.25% and 32.75% while in PMF it was 68.5% and 31.25% respectively. One year postoperatively 3.28 mm increase in inter-commissure width was observed in the NLF group with a marginal increase in the PMF group and a negligible increase in the BFP group. 18.75% partial flap necrosis was seen in BFP, 18.75% in the PMF group, and 6.25% in the NFL group.
CONCLUSIONS: All the flaps are efficacious in treating OSMF, however, NLF stands ahead with its higher reliability owing to its excellent blood supply.

UNASSIGNED: As oral submucous fibrosis (OSMF) is a chronic progressive disorder, the treatment is based on the severity of the disease. Surgical treatment is the only choice for grade III and grade IV OSMF cases because the patient can neither clean his/her mouth nor properly chew. The resulting soft tissue defect requires resurfacing with various well-vascularized tissues such as extraoral flaps, intraoral flaps, microvascular flaps, and allografts that have been used. Reconstruction of the resultant defects proved to be challenging. Till date, none of the flaps has been proven to be effective and is universally accepted for the treatment of OSMF because of various drawbacks of the available techniques. This study was conducted to know whether an endoscopic-assisted platysma flap is associated with better outcomes in terms of ease of operation and postoperative function than the conventional approach.
UNASSIGNED: This study included 40 patients of grade III and grade IV OSMF reporting to the outpatient department of oral and maxillofacial surgery in a tertiary center of North India. These patients were divided randomly into two groups. Group I and Group II had 20 patients each, undergoing endoscopic-assisted platysma flap and non-endoscopic-assisted platysma flap for reconstruction after resection of OSMF bands, respectively. Data were analyzed for the mouth opening, operating time, flap viability, congestion of neck and oral cavity, signs of inflammation, neurologic assessment, and measurement of the drain.
UNASSIGNED: The results showed significant increase in mouth opening from the preoperative value to the values immediately after surgery and at 24 h, 1 week, 15 days, 1 month, 3 months, and 6 months after surgery in both the study groups. Reduced bleeding incidence was found in group I compared to group II, with better postoperative outcomes noted during follow-up. But the mean intraoperative time of the subjects in group I was 130.80 ± 5.5.908 min and in group II was 105.74 ± 2. 491 min. Increased time taken in group I may be due to the long learning curve.
UNASSIGNED: The present study concluded that the Endoscope-assisted technique has a key role during supra and subplatysmal dissection to allow for better accessibility, handling, and visibility of the flap and its orientation in relation to the underlying structures to avoid postoperative complications and to overcome the drawback of platysma myocutaneous flap in reconstruction of OSMF defects.

UNASSIGNED: Large chunks of the tissue are sacrificed during the surgical procedures for the treatment if oral cancers. Our goal was to assess the viability of \"Buccal reconstruction using the anterolateral thigh (ALT) flaps, platysma myocutaneous (PM), and radial forearm free (RFF)\".
UNASSIGNED: Sixty subjects were included in this investigation, and they were divided into 3 groups. The follow-up as accompanied for six months. Comparisons were made for the time for the operations, reduction in the width of the mouth opening and the survival rates of the flaps. The data that was collected for the above two parameters and compared for the significance using the ANOVA, keeping P < 0.05 as significant.
UNASSIGNED: In the subjects with the PM, the width of the mouth opening reduced comparatively greater than that of the subjects who received other two flaps. The reduction in the mouth opening in the PM was significantly greater compared to that of the ALT and RFF. Survival was greater for the groups ALT and RFF compared to PM. Time of the surgery was the greatest for the ALT and least for the PF.
UNASSIGNED: The observations point to the fact that the PF requires more time than that of the other two flaps. The survival was however better for the ALT and RFF. Further research is suggested for suggesting an appropriative flap design.

UNASSIGNED: Clinicians are baffling for reconstruction of small- to medium-sized defects of the oral cavity since time immemorial, each and every flap has its own limitations, ideal flap should be pliable, easily transferrable that can result in a better restoration of form and function of oral mucosa, we have platysma for the same purpose.
UNASSIGNED: We aim to provide surgical technique of the superiorly-based platysma myocutaneous flap with a single neck incision in this study, as well as the flap design, results, and complications associated with age, gender, the recipient site, and the size of the defect.
UNASSIGNED: Study included 20 patients with oral potentially malignant disorders operated under local anaesthesia with wide local excision and reconstruction with platysma myocutaneous flap at a single tertiary care centre.
UNASSIGNED: The association between the variables was calculated using Chi-square tests and paired t tests. P < .05 was considered significant.
UNASSIGNED: Five cases of dehiscence were found at varied sites and flap viability was significantly influenced by location of skin paddle. In between anterior jugular vein and posterior external jugular vein it was 100% viable while on and posterior to the vein, had skin paddle loss. Significant improvement in mouth opening was also seen in Oral Sub-mucous Fibrosis patients.
UNASSIGNED: The platysma flap is a technique sensitive, and its results are promising for the reconstruction of oral defects.

UNASSIGNED: This systematic review aims for the explanation of possible postoperative complications, efficacy and limitations of Platysma myocutaneous flap (PMF) in patients with oral submucosal fibrosis (OSMF).
UNASSIGNED: An electronic search of the literature was undertaken using PubMed, Cochrane Library, clinical trials.gov in the year 2021, using MeSH terms and keywords to identify prospective, retrospective and observational studies, controlled trials as well as case reports over the period 1913 to December 2021, addressing the patients with a mouth opening <25 mm and habit of gutkha chewing. PMFs are used as a form of intervention. Patient follow up period should be mentioned.
UNASSIGNED: A total of 5 publications were included. 2 were prospective studies and 3 were case reports with 79 subjects between the ages of 18 and 45. All included studies reported complications in a non-significant way (p-value = 0.870) with positive results as they impact the patient\'s functional outcome (mouth opening) in a statistically significant manner (p < 0.0001 and 95% CI) with good patient compliance.
UNASSIGNED: PMF is rarely used in routine practice due to their technical difficulty and potential complications like venous congestion and necrosis. In this systematic review, the authors provide valuable insight into the causes of complications and the efficacy of PMFs in OSMF patients. In the process of platysma flap harvesting, it is especially important to preserve the skin flap, arterial perforators and arteries, veins in supra and sub-platysmal flap elevation. Aside from proper flap placement and tunnelling, postoperative care is equally important.

UNASSIGNED: To systematically review the reconstructive options for oral submucous fibrosis utilizing buccal pad of fat versus conventional nasolabial and extended nasolabial flap versus platysma myocutaneous flap.
UNASSIGNED: The succeeding systematic review and meta-analysis addresses the following question, what is the optimal reconstructive option for oral submucous fibrosis?
UNASSIGNED: A systematic electronic and manual database search revealed five relevant articles comparing buccal fat pad, nasolabial flap and platysma myocutaneous flap as reconstructive options in oral submucous fibrosis.
UNASSIGNED: A total of 1538 articles were found across PubMed, Cochrane and clinical trials.gov. Only five relevant articles were selected for the study. Quality assessment of the selected studies was executed by Newcastle-Ottawa scale. Statistical software RevMan (Review Manager [Computer program], version 5.3, Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2014) was used for meta-analysis. Differences in means and risk ratios were used as principal summary measures. The overall estimated effect was categorized as significant where p < 0.05.
UNASSIGNED: Three of the five studies selected favoured buccal fat pad over nasolabial flap owing to its ease of harvest and lesser number of post-operative complications. One study favoured nasolabial flap because of the progressive increase in mouth opening and bulk of the tissue obtained for reconstruction. A single study favoured platysma flap over nasolabial flap although no difference was obtained in mouth opening, owing its excellent tissue bulk, fewer complications compared to the nasolabial flap.
UNASSIGNED: Definitive conclusions cannot be drawn as there are number of limitations in the studies included. However, a general consensus has been towards favouring buccal fat pad over nasolabial flap. The platysma flap owing to its excellent tissue bulk and fewer complications can be considered as an alternative when dealing with defects which are challenging to reconstruct with the buccal fat pad.

OBJECTIVE: Multiple surgical techniques exist in the acute management of auricular avulsion injuries, including reattachment of the tissue as a composite graft, reconstruction using local skin flaps, the pocket principle, the Baudet method, and microvascular repair. This review aimed to compare the success rates of reattachment methods in auricular avulsion injuries.
METHODS: A PubMed search systematically identified cases in which (a) an auricular avulsion injury occurred and (b) reattachment was attempted. Search results were combined with an extensive review of references from published studies. In total, 148 cases were identified. Three reviewers independently graded the final aesthetic result of each case using a 5-point scale. The average grade of each repair was compared to the reattachment method to identify successful techniques.
RESULTS: Microvascular repair was associated with a statistically significant higher success rate compared to all other reattachment methods. Composite graft reattachment also tended to generate better final aesthetic outcomes, but this difference was not statistically significant.
CONCLUSIONS: Microvascular repair of the avulsed segment consistently demonstrated higher success rates. Composite graft reattachment should also be considered under the right circumstances. Overall, microvascular repair and composite graft reattachment should be considered the best options in cases of auricular avulsion repair. The authors share a major concern that other methods that rely on the use of periauricular skin will compromise any future attempts for secondary reconstruction, such as staged procedures using costal cartilage grafts. Manipulation of these tissues and in particular burying of the avulsed ear cartilage is discouraged.
METHODS: 4.

BACKGROUND: Variable flap loss rates for the platysma myocutaneous flap have been reported for the Caucasian and the Asian population, which are 10.1% and 1.6%, respectively. This study was designed to investigate ethnic differences in the number and location of platysmal perforators that influence flap survival rates.
METHODS: The number and location of platysmal perforators were investigated in a total of 60 platysma muscles: bilaterally in 20 Caucasian (13 males and 7 females) and 10 Asian (5 males and 5 females) specimens using cadaveric dissections. Adjustment for inter-individual variability in platysma length and width was performed by standardizing each x-value to mandibular length and each y-value to mandibulo-clavicular distance.
RESULTS: A total of 64% of all detected platysmal perforators were found in the medial half of the muscle following the pathway of the external carotid artery. Individuals of Caucasian ethnicity had a mean number of 7.60 ± 2.0 perforators per side, whereas individuals of Asian ethnicity had a mean number of 13.05 ± 1.76 perforators per side (p < 0.001). Individuals of Asian ethnicity had a statistically significant increased number of platysmal perforators in the medial middle (2.95 ± 1.05 vs. 1.60 ± 1.08; p < 0.001) and lower (1.60 ± 1.35 vs. 0.73 ± 0.85; p = 0.003) regions of the platysma compared to those of Caucasian individuals.
CONCLUSIONS: A significantly higher number of platysmal perforators were identified in the investigated Asian population. This provides a potential explanatory model for the reported lower platysma myocutaneous flap loss rates in the Asian population than in the Caucasian population.

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Objective:To study the method and feasibility in reconstruction of platysma myocutaneous flap of defects caused by hypopharyngeal cancer resection. Method:Twelve cases underwent reconstruction with the platysma myocutaneous flap of hypopharyngeal soft defect were investigated. All cases received 2 times preoperative induction chemotherapy followed by hypopharyngeal cancer resection with laryngeal function preservation and the neck lymph node dissection. Platysma myocutaneous flap was used to repair the hypopharyngeal soft tissue defect. Result:All the flaps survived. Three weeks after surgery, all patients can eat without pharyngeal fistula and dysphagia, but pharyngeal foreign body sensation. Three cases of cough after surgery, improved after training. After postoperative radiotherapy, flap survived without secondary necrosis. Laryngeal function of all cases was retained, and only one case with cannula maintained. Conclusion:Preoperative induction program can effectively reduce the lesion. The placenta myocutaneous flap has rich blood supply, strong anti-infectivity. It is an effective method to repair the hypopharyngeal tissue defect with the placenta myocutaneous flap.