Modified Platysma Myocutaneous Flap Reconstruction for Advanced Laryngeal Carcinoma: A Multicenter Retrospective Cohort Study.

Abstract

This study presents a modified platysma myocutaneous flap technique for reconstructing extensive laryngeal defects in patients with advanced-stage transglottic laryngeal carcinoma. A retrospective cohort analysis was conducted on patients undergoing organ-preserving partial laryngectomy followed by reconstruction using a modified platysma flap. Primary endpoints included decannulation rate and 3-year overall survival. Functional recovery of respiration, swallowing, and phonation was evaluated using validated scales. Sixty patients (mean age: 62.85 ± 6.09 years) were enrolled across two centers. The overall decannulation rate was 85.0%, with significantly higher success rates observed in the partial laryngectomy group (p < 0.05). The 3-year survival rate was 78.3%. Swallowing and phonatory functions were well preserved, with median scores of 2 and 1, respectively. The technique was associated with a low incidence of flap-related complications (13.3%) and favorable mucosalization outcomes. The modified platysma flap offers a practical and effective reconstructive strategy for laryngeal defects in advanced carcinoma, achieving satisfactory respiratory decannulation and preservation of laryngeal function with minimal morbidity.