Delayed histological changes in cutaneous portion of pectoralis major flaps employed in upper aero-digestive tract reconstruction.
Our aim was to determine whether histological changes occur in the cutaneous portion of pectoralis major flaps employed for upper aero-digestive tract reconstruction and, if present, to characterize these changes and try to infer their cause. Seven patients submitted to repair of aero-digestive tract defects secondary to cancer resection with pectoralis major myocutaneous flap were included in this study. All patients received adjuvant radiotherapy. Biopsies were taken from: the cutaneous portion of the flap; buccal mucosa; irradiated neck skin and chest skin opposite the donor site. Histological changes toward a "mucosalization" occur in the cutaneous portion of the pectoralis major flaps, characterized by disappearance of the horny layer or a reduction of its thickness and a decrease of the amount of cutaneous appendages. These changes are probably a result of continuous exposure to the intraoral environment in association with radiotherapy effects and may represent an advantageous adaptation for the patient.
Pinto
Fábio Roberto
FR
Department of Head and Neck Surgery, Hospital de Ensino da Faculdade de Medicina do ABC, São Bernardo do Campo, Brazil. pintofr@uol.com.br
Kanda
Jossi L
JL
Diniz
Mariana T
MT
Santos
Cláudia P
CP
Zveibil
Deborah K
DK
D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000473:pathology; D010369:Pectoralis Muscles / Q000473:pathology*; D018714:Radiotherapy, Adjuvant; D019651:Plastic Surgery Procedures; D012867:Skin / Q000473:pathology*; D013524:Surgical Flaps; D013997:Time Factors