The lower trapezius island myocutaneous flap for reconstruction of soft tissue of the lateral skullbase and neck

Background: The lower trapezius island myocutaneous flap (LTIMF) has been described as a method of reconstruction after excision of carcinoma of the head and neck. A high rate of failure and confusion regarding the nomenclature of its vascular supply has been reported in the literature. Methods: The data on six patients whose lateral skullbase and upper neck were reconstructed with an LTIMF were assessed prospectively. Results: There was one major flap loss, and one previously irradiated patient had a minor dehiscence. One patient had a small haematoma at the donor site. All wounds were closed primarily and preservation of the accessory nerve to the superior fibres of the trapezius muscle enabled almost normal abduction of the arm. Conclusions: The anatomy and complications of the LTIMF are reviewed and certain recommendations are made to improve its reliability.