Outcomes of Pectoralis Major Myocutaneous Flap in the Reconstruction of Head and Neck

Shashidhar Kallappa,Akshatha Shetty Mijar

doi:10.11648/j.ijcocr.20200502.15

Abstract

Pectoralis major myocutaneous (PMMC) flap is versatile flap used for reconstruction of various head and neck defects created after excision of tumors. Due to the rapid advancement of reconstructive microsurgery, micro vascularised free flap transfer is becoming the main method of head and neck reconstruction. Presently PMMC flap reconstruction is used as an option for salvage surgery post free flap transfer failure and also in patients who are poor candidates for free flap transfer. However in developing countries like India where there are limited resources and the patient’s presents in advanced stage of the disease PMMC flap is a viable option for reconstruction. Aim is to study the outcome of PMMC flap reconstruction in head and neck malignancy. A prospective analysis was done with 20 patients who underwent wide local excision with marginal or hemi mandibulectomy with PMMC flap reconstruction and neck dissection from January 2017 to January 2019 in tertiary care center. Follow up was done for every 2 weeks for first 2 months, then every month for a period of 6 months. Out of all the patients who underwent PMMC flap reconstruction, 2 patients developed partial flap necrosis, 1 had wound dehiscence and fistula and 1 patient had local recurrence. For remaining patients no complications were noted in the follow up period.

Highlights

Reconstruction of defects in the head and neck region caused due to surgical excision of the malignancy is a daunting task because it leads to both functional as well as cosmetic deficits, it has an impact on the day today life of the patient
Pectoralis major myocutaneous (PMMC) flap was first described by Ariyan [4] since it has been used for reconstruction of head and neck defects either after primary extirpation or surgical salvage after radiation failure and considered as a workhorse for reconstruction in many head and neck surgeries
PMMC flap was first described by Ariyan [4] post that it has widely used in head and reconstruction worldwide

Summary

Introduction

Reconstruction of defects in the head and neck region caused due to surgical excision of the malignancy is a daunting task because it leads to both functional as well as cosmetic deficits, it has an impact on the day today life of the patient. Pectoralis major myocutaneous (PMMC) flap was first described by Ariyan [4] since it has been used for reconstruction of head and neck defects either after primary extirpation or surgical salvage after radiation failure and considered as a workhorse for reconstruction in many head and neck surgeries. Advantages of this flap reconstruction will be its simple anatomy, location adjacent to head and neck region, can be elevated as vascular island flap, it has the shorter operative time, easy to execute and low donor site morbidity [5, 6]

Methods

Results

Conclusion