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Drs Gady Har-El, Yosef Krespi, and Rivi Har-El of the State University of New York Health Science Center, Brooklyn (NY) Veterans Administration Medical Center, at the Eastern Section meeting of The Triological Society in Toronto, Canada, on January 27, 1989, described the myocutaneous flaps used in head and neck surgery; ie, the pectoralis major myocutaneous flap, the trapezius, and the rhomboid trapezius myocutaneous flaps. They described the anatomy in detail, including the vascular supply, and illustrated their function. When using these flaps, their short-term goals include preventing frozen shoulders, avoiding tension in the recipient's suture line, and avoiding torsion of the pedicle. A long-term goal is full range of motion of the shoulder. In the first week in their physical therapy program, they have active movement of the alternate muscles in the shoulder group. In the second to fifth week, they institute passive movement in the pectoralis muscle, and, finally,
PARNES S. Physical Therapy Program Following Myocutaneous Flap Reconstruction of the Head and Neck. Arch Otolaryngol Head Neck Surg. 1989;115(7):779. doi:10.1001/archotol.1989.01860310017011