title: Subclavicular pectoralis major myocutaneous flap for optimal reconstruction of large orbitozygomatic defects: a case report.
abstract: Since the introduction of microvascular free flaps, the pectoralis major myocutaneous flap (PMMF) has been relegated to background for most reconstructive surgeons. The objective of this article is to show the advantages of cervicofacial defects reconstruction with PMMF using the subclavicular plane route in a challenging clinical case. An 83-year-old man presented with cutaneous temporomalar lesion with orbital spread. Tumor resection was performed, including 12 × 11 cm skin and subcutaneous tissue, overlying zygomatic and malar bone, and orbital exenteration. Radical parotidectomy and functional neck dissection were performed. PMMF was chosen as reconstructive option routing the pedicle to the subclavicular plane. The length of the pedicle was 31 cm. The subclavicular route for PMMF increases the flap's length and arc of rotation compared with the conventional supraclavicular one. This procedure decreases the bulk of the PMMF pedicle which makes it functionally and cosmetically favorable. By using this modification, we may widen the "safe" reconstructive possibilities.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Lorena
authors.initials: L
authors.lastname: Pingarron
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Julian
authors.initials: J
authors.lastname: Ruiz
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Rey
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Lourdes
authors.initials: L
authors.lastname: Maniegas
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Roson
authors.affiliation: Department of Oral and Maxillofacial Surgery, Hospital Universitario Fundación Jiménez Díaz, Madrid, Spain.
authors.forename: Dolores
authors.initials: D
authors.lastname: Martinez
keywords: orbitozygomatic; pectoralis major; reconstruction; subclavicular route