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April 1969

Z-Plasty in Head and Neck Surgery

Author Affiliations

Iowa City
From the Department of Otolaryngology and Maxillofacial Surgery, University of Iowa Medical Center, Iowa City.

Arch Otolaryngol. 1969;89(4):574-584. doi:10.1001/archotol.1969.00770020576004

THE Z-plasty is one of the most widely employed special techniques in reconstructive surgery. Consisting of the transposition of two triangular flaps, it serves as the fundamental method of releasing linear contraction.

Historical Background  Although Hippocrates referred to Z-plasty in his writings, Denonvilliers1 is credited for the latter-day introduction of the transposed triangular flaps. In 1856 he employed this technique for the correction of a lower lid ectropion caused by a contracted scar of the cheek. Four years later, Szymanowski2 used a Z-incision for the relief of displacement of the angle of the mouth—apparently this method was well known to him. Piéchaud3 reported the use of a Z-type incision for the relief of scar contracture in 1896. Davis4 credits Berry and Legg with having employed the Z-incision for adjusting the malaligned vermilion border in a poorly repaired cleft of the lip. In 1914 Morestin5 devised a

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