The pectoralis major flap in head and neck reconstruction: first 500 patients.
OBJECTIVE
The aim of this study was to evaluate almost 20 years of using the pectoralis major flap in head and neck reconstruction at the Department of Maxillofacial Surgery, Zagreb.


METHODS
In the period from 1981 to 1999, a total of 506 pectoralis major flaps were used for head and neck reconstruction in 500 patients. In all cases the flap was used after surgical resection of an advanced malignant tumour of the head and neck.


RESULTS
The tumours were intraoral in 387 cases (77%), pharyngeal in 78 cases (15%) and on the skin in 10 cases (5%). The defect was located in the mucosal lining in 407 (81%), skin in 43 (8%), both intra- and extraoral in 53 (10%) patients. Bone defects occurred in 65 patients. In 31 patients (6%), the pectoralis major flap was used in combination with other flaps (deltopectoral, tongue, trapezius and free flaps). Complications occurred with 168 flaps (33%), but total flap necrosis was only seen in 10 patients (2%). Surgical treatment of complications was necessary in 87 patients (17%).


CONCLUSIONS
Despite the increasing use of microvascular reconstruction, the pectoralis major myocutaneous flap continues to be the most universal major flap in head and neck reconstruction.
Milenović
Aleksandar
A
Department of Maxillofacial Surgery (Head: Prof. Dr. Miso Virag), University Hospital Dubrava, Zagreb, Croatia. alemilenovic@hotmail.com
Virag
Miso
M
Uglesić
Vedran
V
Aljinović-Ratković
Naranda
N
D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D010369:Pectoralis Muscles / Q000637:transplantation*; D011183:Postoperative Complications; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*; D019233:Retreatment / Q000706:statistics & numerical data; D016038:Skin Transplantation / Q000379:methods; D013524:Surgical Flaps / Q000009:adverse effects / Q000706:statistics & numerical data*