Lambeaux neurocutanés appliqués à la chirurgie cervicofaciale: étude anatomique de faisabilité à partir des branches du plexus cervical superficiel

Objective: To evaluate the feasibility of neurocutaneous flaps for head and neck surgery using the cervical superficial plexus branches. Methods: Anatomic study on cervical superficial plexi (focusing on the great auricular and cervical transverse nerves) of five fresh specimens, which were injected with green colored latex. Results: A constancy of anatomic landmarks has been observed with little inter-individual variability. The cervical superficial plexus branches were easily isolated, their length and course not varying much. Each cervical superficial plexus nerve is accompanied by a perinervous artery, essential condition to a neurocutaneous flap. We privileged the great auricular nerve for its superior length and diameter, in order to easy the raise of the flap. We took it at the low mastoidian level, pediculed on the great auricular nerve with a point on the posterior border of the sterno-cleido-mastoidian muscle. Pedicule size is 7 to 10. cm allowing to reach ipsilateral alae of the nose, the chin or the pinna. Developing this technique for oropharyngeal reconstruction (internal side of the cheek, anterior floor of mouth...), whereas not realized in this study, must be considered. Conclusions: The anatomic study showed the cervical superficial plexus constancy with the systematic presence of a perinervous pedicle siding each branch. The great auricular nerve is a good candidate for the raise of a neurocutaneous flap. A standardized surgical procedure must be established before any clinical study.