Pectoralis major myocutaneous flap for reconstruction of partial circumference hypopharyngeal defects

Abstract

Reconstruction of partial defects of the Hypopharynx and Cervical esophagus following resection for locally advanced carcinoma, by pectoralis major myocutanous flap (PMMF) was studied in 30 consecutive cases over a period of 5 years from 1988–1992 at the Tata Memorial Hospital. Patients with circumferential excisions were excluded for the purpose of this study. Two patients died in the post-operative period due to massive upper GI haemorrhage and cerebrovascular accident. These 2 patients were excluded from further analysis. Satisfactory oral intake was achieved in 26 (85%) patients. Pharyngocutanous fistula (PCF) developed in 10 (29%) patients. Anastomotic strictures developed in 4 patients, out of 2 were benign and 2 were due to recurrence of disease. Median hospital stay in patients who developed PCF was 39 days as against 14 days in those who did not develop PCF. With a minimum follow up of two years 47% patients are dead of disease, 32% are lost to follow and only 14% are alive and free of disease. Statistical analysis using univariate and multivariate tests failed to reveal any significant predisposing risk factors for PCF. Patch PMMF for the reconstruction of partial defects of the hypopharynx is a safe and reliable procedure.