Abstract
The vascular basis of ischemic and congestive changes in neck flaps with various incisions is presented in view of recent work presented in the German literature. A single transverse midneck incision combined with a far lateral venrical incision which preserves the arterial supply to the skin of the neck is suggested. It is equally applicable to thyroid surgery, conservation laryngeal surgery, laryngectomy with neck dissection and, by adding an upper limb, to intraoral (commando) procedures. Surgery performed four to six weeks following preoperative irradiation of 5,000 to 5,600 rads, and following irradiation failure of 5,500 to 9,100 rads in laryngeal and oral lesions has been gratifying.

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