title: Pectoralis major myocutaneous flap reconstruction in head and neck surgery--experience with 60 cases.
abstract: The aim of this paper is to evaluate the results of the use of the pectoralis major myocutaneous flap for reconstruction in 60 otolaryngology--head and neck patients over a five year period. There were 52 patients with Stage III (30%) and Stage IV (70%) untreated squamous cell carcinomas. Of the eight recurrent tumours, three patients had nasopharyngeal carcinoma with extensive post-radiation neck failures requiring extended neck dissections and flap reconstruction. The oral cavity and oropharynx were the predominant sites for reconstruction accounting for 70% of the operations performed. Twenty-eight patients had composite resections, ten with pectoralis osteo-myocutaneous flap incorporating a vascularised split sternum bone graft and titanium plate fixation for immediate mandibular reconstruction. All 52 patients underwent post-operative radiation. Major necrosis did not occur but minor tip necrosis of the skin island occurred in two cases (3%). The mean hospitalisation was 19 days for all patients and 21 days for patients with composite resections. The pectoralis major myocutaneous flap in our experience is not only a versatile flap but also a very reliable and robust flap for single stage immediate head and neck reconstruction.
authors.affiliation: Department of Otolaryngology, Singapore General Hospital.
authors.forename: C T
authors.initials: CT
authors.lastname: Chew
authors.forename: R
authors.initials: R
authors.lastname: Stanley
authors.forename: R
authors.initials: R
authors.lastname: Peck
authors.forename: S C
authors.initials: SC
authors.lastname: Chew
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D006760:Hospitalization; D006801:Humans; D007902:Length of Stay; D008297:Male; D009055:Mouth / Q000601:surgery; D010369:Pectoralis Muscles / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology; D013249:Sternum / Q000601:surgery; D013524:Surgical Flaps / Q000473:pathology