Cervicofacial Advancement Rotation Flap for Reconstruction of Large Soft Tissue Defects in the Head and Face Area

BACKGROUND: Reconstruction of head and facial soft tissue defects poses significant surgical challenges. As the most visually prominent anatomic region, successful reconstruction necessitates complete lesion excision while optimizing aesthetic and functional preservation. This study assesses the surgical technique and clinical feasibility of cervicofacial advancement rotation flaps for such reconstructions. METHODS: A retrospective analysis was conducted on 9 consecutive patients (6 males, 3 females; mean age 49.6±16.2 y, range: 20-77) who underwent cervicofacial advancement rotation flap reconstruction for head and facial soft tissue defects between November 2016 and January 2023. Flap dimensions, pedicle location, and rotation vectors were tailored to defect characteristics following oncological resection. RESULTS: Among the 9 cases treated, neither concurrent lymphadenectomy nor parotidectomy was performed. Eight patients achieved complete survival of the cervicofacial advancement rotation flaps, while complications included incomplete wound healing, canthal traction, and hypertrophic scarring in 1 case each. Overall flap viability was excellent, with color and texture well-matched to the recipient site, and cervical range of motion remained unrestricted. CONCLUSIONS: The cervicofacial advancement rotation flap is a highly effective reconstructive option for head and facial soft tissue defects. This technique provides a straightforward solution by incorporating the platysma muscle during neck dissection-ensuring reliable vascular supply-and enhancing flap flexibility. Consequently, it allows for a greater range of motion during flap transfer and broader coverage in reconstruction.