title: Pectoralis Major Myocutaneous Flap for Head and Neck Defects in the Era of Free Flaps: Harvesting Technique and Indications.
abstract: The role of the pectoralis major myocutaneous flap (PMMF) in head and neck reconstruction is challenged recently due to its natural drawbacks and the popularity of free flaps. This study was designed to evaluate the indications and reliability of using a PMMF in the current free flap era based on a single center experience. The PMMF was harvested as a pedicle-skeletonized flap, with its skin paddle caudally and medially to the areola, including the third intercostal perforator, preserving the upper one third of the pectoralis major muscle. The harvested flap was passed via a submuscular tunnel over the clavicle. One hundred eighteen PMMFs were used in 114 patients, of which 76 were high-risk candidates for a free flap; 8 patients underwent total glossectomy, and 30 underwent salvage or emergency reconstruction. Major complications occurred in 4 patients and minor complications developed in 10. Tracheal extubation was possible in all cases, while oral intake was possible in all but 1 case. These techniques used in harvesting a PMMF significantly overcome its natural pitfalls. PMMFs can safely be used in head and neck cancer patients who need salvage reconstruction, who are high risk for free flaps, and who need large volume soft-tissue flaps.
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, Shantou, 515031, P. R. China.
authors.forename: Muyuan
authors.initials: M
authors.lastname: Liu
authors.affiliation: Department of Head and Neck Surgery, Cancer Center, Sun Yat-sen University, Guangzhou, 510080, P. R. China.
authors.forename: Weiwei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, Shantou, 515031, P. R. China.
authors.forename: Xihong
authors.initials: X
authors.lastname: Yang
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, Shantou, 515031, P. R. China.
authors.forename: Haipeng
authors.initials: H
authors.lastname: Guo
authors.affiliation: Department of Head and Neck Surgery, Cancer Hospital of Shantou University Medical College, Shantou, 515031, P. R. China.
authors.forename: Hanwei
authors.initials: H
authors.lastname: Peng
mesh_terms: D000368:Aged; D006258:Head and Neck Neoplasms / Q000601:surgery*; D006801:Humans; D064827:Myocutaneous Flap / Q000009:adverse effects / Q000601:surgery*; D010369:Pectoralis Muscles / Q000601:surgery; D011183:Postoperative Complications / Q000453:epidemiology* / Q000209:etiology; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000379:methods*