title: Use of the external pectoralis myocutaneous major flap in anterior skull base reconstruction.
abstract: Despite the emergence of free tissue transfer, the pectoralis major myocutaneous flap (PMMF) still has a role in anterior base skull reconstruction (when free tissue transfer is not feasible). The aim of this study is to evaluate the results of external PMMF in anterior skull base reconstruction. A retrospective study from 1977 to 2006 was conducted at Yale New Haven Hospital. 16 patients (mean age 64 years), presenting with a malignant tumour of the anterior base skull, were included. The primary pathology was recurrent squamous carcinoma. Tumour resection resulted in orbital exenteration in 60%, and bone resection of the anterior skull base in 81% of patients. The initial skin defect was 49 cm(2) (range 16-100 cm(2)). The PMMF was the primary reconstructive choice in 87%, and utilized after free flap failure in two cases. Three minor complications were noted. Orbital exenteration and anterior base skull resection is a surgical procedure that leads to significant reconstructive challenges. The PMMF remains a safe and versatile reconstructive tool in anterior skull base tumour resection. The externalized pedicle allows this flap to reach periorbital and anterior skull base.
authors.affiliation: Yale Plastic Surgery, New Haven, CT, USA. natacha.kadlub@gmail.com
authors.forename: Natacha
authors.initials: N
authors.lastname: Kadlub
authors.forename: Joseph H
authors.initials: JH
authors.lastname: Shin
authors.forename: Doug A
authors.initials: DA
authors.lastname: Ross
authors.forename: T
authors.initials: T
authors.lastname: Della Torre
authors.forename: Edward
authors.initials: E
authors.lastname: Ansari
authors.forename: John A
authors.initials: JA
authors.lastname: Persing
authors.forename: Stephen
authors.initials: S
authors.lastname: Ariyan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D058752:Free Tissue Flaps / Q000637:transplantation*; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009918:Orbital Neoplasms / Q000601:surgery; D010369:Pectoralis Muscles / Q000637:transplantation*; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D019292:Skull Base Neoplasms / Q000601:surgery*