Pectoralis major myofascial flap in head and neck reconstruction: indications and outcomes.
OBJECTIVE
To review the pectoralis major myofascial (PMMF) flap in head and neck reconstruction.


METHODS
Twenty-seven consecutive patients who underwent a PMMF reconstruction between March 1, 2001, and October 1, 2004, were retrospectively reviewed, which, to date, has generated the largest documented series among the world literature. Data acquisition centred on indications for use, tumour staging, defect location, type of wound, and complications (major and minor).


RESULTS
Thirteen patients had resections of the primary tumour, whereas 13 others had recurrent disease. Stages varied from T0 to rN3. A variety of defects were filled, but the majority of defects were in the oral cavity (13; 48%). Indications ranged from pure soft tissue filling to salvage of previously failed reconstructions. The outcomes were evaluated as 24 (89%) successes and 6 (22%) major and 6 (22%) minor complications overall, but when only considering cases done for reconstructive salvage, the failure rate is high (3; 50%).


CONCLUSIONS
The PMMF flap remains a successful reconstructive option; however, when used in the context of previously failed reconstructive efforts, the morbidity of the PMMF flap is much higher.
Ethier
Jean-Luc
JL
Department of Surgery, Division of Otolaryngology, Dalhousie University, Halifax, Nova Scotia.
Trites
Jonathan
J
Taylor
S Mark
SM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome