Why is it not advisable to use a trapezius flap after a radical neck dissection?

The trapezius flap is a surgical technique often used for reconstructive purposes in the head and neck region. However, its use post-radical neck dissection is limited due to potential complications associated with vascular supply, particularly the preservation of the transverse cervical artery.

In a radical neck dissection, the transverse cervical artery may be sacrificed along with other structures such as lymph nodes and surrounding tissue. This artery is crucial for supplying blood to the trapezius muscle. Without adequate vascular supply, the viability of the trapezius flap can be compromised, potentially leading to flap necrosis and failure.

Moreover, a sacrificed transverse cervical artery means that even if the trapezius muscle is viable at the time of transfer, it may not receive enough blood flow post-operatively due to its reliance on this artery for nutrition. Therefore, the flaps may not heal properly, and the overall success of the reconstructive procedure can be adversely affected.

Understanding the role of blood supply in surgical planning highlights why the transverse cervical artery's status is paramount when considering the use of a trapezius flap following a radical neck dissection.