title: Delayed histological changes in cutaneous portion of pectoralis major flaps employed in upper aero-digestive tract reconstruction.
abstract: 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.
authors.affiliation: Department of Head and Neck Surgery, Hospital de Ensino da Faculdade de Medicina do ABC, São Bernardo do Campo, Brazil. pintofr@uol.com.br
authors.forename: Fábio Roberto
authors.initials: FR
authors.lastname: Pinto
authors.forename: Jossi L
authors.initials: JL
authors.lastname: Kanda
authors.forename: Mariana T
authors.initials: MT
authors.lastname: Diniz
authors.forename: Cláudia P
authors.initials: CP
authors.lastname: Santos
authors.forename: Deborah K
authors.initials: DK
authors.lastname: Zveibil
mesh_terms: 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