title: The subclavicular versus the supraclavicular route for pectoralis major myocutaneous flap: a cadaveric anatomic study.
abstract: The aim of this paper was to determine if the subclavicular route of rotation improved the pectoralis major myocutaneous flap's ability to reach head and neck sites in comparison to the traditional supraclavicular rotation. We dissected 50 flaps in 25 fresh adult male cadavers. The length of the pedicle and the flap's ability to reach five anatomical head and neck sites (laryngeal prominence of thyroid cartilage, mentum, angle of the mandible, external auditory canal, and orbit) were tested by supraclavicular and subclavicular rotation. Although the average length of the flap's pedicle was higher when the subclavicular rotation was employed, there was no statistical difference between the two techniques concerning the flap's ability to reach the studied sites. Our results suggest that the subclavicular route apparently adds little to the reconstruction of head and neck defects using the pectoralis major myocutaneous flap. We believe that the indication of this technique should be evaluated on a case-by-case basis before it is recommended to keep from unnecessarily increasing the potential morbidity of the reparative procedure.
authors.affiliation: Department of Head and Neck Surgery, Hospital de Ensino da Faculdade de Medicina do ABC, Rua Silva Jardim no 470, São Bernardo do Campo 09715-090, Brazil.
authors.forename: Christiana Maria Ribeiro Salles
authors.initials: CM
authors.lastname: Vanni
authors.forename: Fábio Roberto
authors.initials: FR
authors.lastname: Pinto
authors.forename: Leandro Luongo
authors.initials: LL
authors.lastname: de Matos
authors.forename: Maria Graciela Luongo
authors.initials: MG
authors.lastname: de Matos
authors.forename: Jossi Ledo
authors.initials: JL
authors.lastname: Kanda
mesh_terms: D002102:Cadaver; D002968:Clavicle; D006257:Head / Q000601:surgery*; D006801:Humans; D008297:Male; D009333:Neck / Q000601:surgery*; D010369:Pectoralis Muscles / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps