title: Pectoralis Major Myocutaneous Flap in Primary and Salvage Head and Neck Cancer Surgery.
abstract: OBJECTIVE
  To analyze the oncologic, functional, and esthetic results of using the pectoralis major myocutaneous flap (PMMF) from November 2001 to April 2012 at the Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana (Ljubljana, Slovenia).
  
  
  METHODS
  Patients with squamous cell carcinoma of the head and neck (SCCHN) who underwent tissue defect reconstruction with a PMMF were identified from a prospective database. Medical and surgical records were reviewed for information on clinical characteristics, treatment, and outcome and specifically for indications for the PMMF, wound healing, flap vitality, functional results, and esthetics.
  
  
  RESULTS
  Forty PMMFs were used in 39 patients with SCCHN. With respect to previous therapy and prognosis, patients were sorted into a primary surgery group (19 patients) and a salvage surgery group (20 patients with recurrent disease). Statistically better locoregional control and disease-free survival were observed in the first group. Wound healing was completed in 32 patients (median time from surgery, 22 days). Three cases exhibited partial PMMF necrosis. Functional results, occlusion of pharyngocutaneous fistula, speech intelligibility, upper limb dysfunction, and esthetic outcome did not differ between the 2 groups.
  
  
  CONCLUSIONS
  The PMMF is a reasonable choice for primary head and neck cancer surgery and in salvage procedures. Its use is characterized by vitality, a reasonably short recovery time, and a favorable esthetic outcome at the donor site in most patients.
authors.affiliation: Consultant, Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia. Electronic address: aleksandar.anicin@kclj.si.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Aničin
authors.affiliation: Consultant, Department of Otorhinolaryngology and Cervicofacial Surgery, University Medical Center Ljubljana, Ljubljana, Slovenia.
authors.forename: Robert
authors.initials: R
authors.lastname: Šifrer
authors.affiliation: Professor, Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
authors.forename: Primož
authors.initials: P
authors.lastname: Strojan
mesh_terms: D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000601:surgery*; D005260:Female; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010369:Pectoralis Muscles / Q000601:surgery*; D016879:Salvage Therapy; D012867:Skin; D013524:Surgical Flaps