Reconstruction of Composite and Complex Head and Neck Defect Post Supra Major Oncological Resection by using Bilateral Pectoralis Major Myocutaneous Flap

Abstract

Aim: The aim of study is to identify the outcome of Bilateral PMMC flaps for major Head and Neck defects following supra major oncological excision of growth. Study: Hospitals in India get many T4 Head & Neck malignancy. They are operated by Oncosurgeons but its reconstruction becomes challenging for the Plastic surgeons. We present a case series of reconstruction of major Head and Neck composite defect resulting from major post oncological resection where we have used Bilateral pectoralis major Myocutaneous flap to cover the resultant defect. Although microsurgical technique is available, but it’s costly. Pectoralis major flap is a robust flap, it requires lesser learning curve and lesser anaesthesia time, so the complications are less and healing is also faster. It is single stage surgery so that after healing Radiotherapy could be started as early as possible. Method: Fifteen patients since 2013 operated by chief surgeon were included in this study. After supra major excision of growth the inner lining was covered by contralateral PMMC and ipsilateral PMMC was used to cover the external defect. Conclusion: Bilateral PMMC flap is an answer to cover the defect following supra major excision of T4 Oral Malignancy. It is a pedicled flap, time taken is lesser than Microvascular Reconstruction and it could be done where microsurgical expertise is lacking. It is single stage surgery so radiation could be started early. So it’s a good answer to cover major post oncological surgical defect.