Medial Neck and Submandibular Scar Contractures: Anatomy and Treatment

Abstract

Midline neck contracture is caused by scars that spread from the chin to the sternal manubrium and involve the submental and submandibular regions. The contractures can spread on the face and chest wall. The scars are often thick and rough and present a functional, as well as severe cosmetic, defect. In terms of treatment, the most important task is restoration of the surface with well-matched skin from the remaining neck skin on the lateral surfaces. Therefore, lateral neck skin undergoes expansion, even though the technique can be complicated by skin necrosis. After establishing that the anterio-lateral neck skin has axial blood supply, the middle contracture can be released with neck split flaps from the neck lateral surfaces. Stable blood circulation allows mobilization of healthy skin that does not damage axial vessels and transposition on the anterior neck with tension. This method of reconstruction and results are presented in this chapter.