Is there still a role for bilobed/bipaddled pectoralis major myocutaneous flap for single-stage immediate reconstruction of post ablative oncologic full-thickness defects of the cheek?

Abstract

Reconstruction of full-thickness defects of the head and neck is a challenge. In this clinical study, we assessed the role of the bilobed/bipaddled pectoralis major myocutaneous flap (PMMF) for the reconstruction of large full-thickness defects of the cheek, after resection of oral cancer. After resection of oral cancer, 62 cases of through-and-through defects of the oral cavity were reconstructed using folded/bipaddled/bilobed PMMF flap. All were males and presented with locally advanced oral squamous cell carcinoma (SCC), which involved the buccal mucosa and gingivo buccal sulcus (n = 53) and gingivo buccal sulcus + lip (n = 9). All the flaps survived, and no patient developed a major complication. The most common complication in the current series was wound dehiscence. In 8% of cases, wound dehiscence was found at the donor site; in 6.45% of cases, dehiscence was present at the recipient site; and in 4.83% of cases, dehiscence was present at the neck. All the wounds healed secondarily with regular dressings. The bilobed/bipaddled PMMF is a straightforward and reliable flap that provides an effective mechanism to reconstruct full-thickness cheek defects while avoiding the complexity of microvascular free flaps. The bilobed/bipaddled PMMF has become our preferred reconstruction option for large full-thickness defects after resection of oral carcinoma.