由于胸大肌和斜方肌肌皮瓣的广泛使用,头颈部整复外科迅速发展。大多数头颈部缺损,单独用一种肌皮瓣或者再联合使用皮瓣就能够修复。然而,并非所有病例都能用标准皮瓣成功修复,不是因为旋转角度不够,就是因为缺损区较大。本文介绍了顶、枕、项肌皮瓣的设计和制作,同的附有三个临床病例。瓣的设计和制作顶、枕、项肌皮瓣含有头皮,枕肌和帽状腱膜,还有斜方肌上方的皮肤和皮下组织。皮瓣的蒂要有足够的宽度,必须包括枕动、静脉和颞浅动、静脉的顶支。前 Due to the extensive use of pectoralis major and trapezius myocutaneous flaps, head and neck surgery has developed rapidly. Most of the head and neck defects, alone with a myocutaneous flap or combined with the flap can be repaired. However, not all cases can be successfully repaired with standard flaps, not because of lack of rotation, or because of the large defect area. This article describes the top, pillow, muscle flap design and production, with the attached three clinical cases. Design and manufacture of flap The top, occipital and pedicel skin flaps contain the scalp, occipital and aponeurosis, as well as the skin and subcutaneous tissue above the trapezius. Flap pedicle to have sufficient width, must include occipital, venous and superficial temporal artery and vein of the top branch. before