Pectoralis Major Myocutaneous Flap Reconstruction with Deltopectoral Flap Incision in the Surgical Treatment of Oral Cancer
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Abstract
Background: One of the main goals of patient management is the reconstruction of tissue defects following surgical resection for oral cancer. A variety of flaps are used for this purpose, the most frequent being a Pectoralis Major Myocutaneus Flap (PMMF). This flap is currently widely used for the reconstruction of different defects of the head and neck. Methods: Surgical resection of the primary tumor, as well as neck dissection, was performed on 29 patients with oral squamos cell carcinoma between 2011–2017 in City Hospital #1 and Surgical Training Clinic of Azerbaijan Medical University. PMMF was used for the reconstruction of defects using a deltopectoral flap incision. Result: In 22 patients (75.8 %) primary healing occurred following a PMMF. Four patients (13.8 %) suffered PMMF necrosis and were taken back to the operating room for secondary reconstruction with a deltopectoral flap. In three patients (10.3%) the skin of the flap underwent necrosis, resulting in the development of an orocutaneus fistula. Conclusion: Use of PMMF with deltopectoral flap incision enables deltopectoral flap availability. This flap can then be used early on or if PMMF fails.
1. Ariyan S. The pectoralia major myocutaneous flap. The ver- satile flap for reconstruction in head and neck.. Plast. Recon- str. Surg., 1979;63:73-81.
2. Ariyan S. Further experiences with the pectoralis major my- ocutaneous flap for the immediate repair of defects from ex- cisions of head and neck cancers. Plastic and Reconstructive Surgery. 1979 Nov;64(5):605-12.
3. Baek SM, Lawson W, Biller HF. An analysis of 133 pec- toralis major myocutaneous flaps. Plastic and reconstructive surgery. 1982 Mar;69(3):460-9.
4. Ossoff RH, Wurster CF, Berktold RE, Krespi YP, Sisson GA. Complications after pectoralis major myocutaneous flap reconstruction of head and neck defects. Archives of Otolar- yngology. 1983 Dec 1;109(12):812-4.
5. Friedrich W, Lierse W, Herberhold C. Myocutaneous vas- cular territory of the thoracoacromial artery. A topograph- ical and morphometric study of the arterial vascularization of the pectoralis major myocutaneous flap. Acta anatomica.
1988;131(4):284-91.
6. Wilson JS, Ylacoumettis AM, O’Neill T. Some observations on 112 pectoralis major myocutaneous flaps. The American journal of surgery. 1984 Feb 1;147(2):273-9.
7. Brusati R, Collini M, Bozzetti A, Chiapasco M, Galioto S.The pectoralis major myocutaneous flap: Experience in 100 consecutive cases. Journal of Cranio-Maxillofacial Surgery.
1988 Jan 1;16:35-9.
8. Robertson MS, Allison RS. The pectoralis major muscle in head and neck reconstruction. Australian and New Zealand Journal of Surgery. 1986 Oct;56(10):753-7.
9. Josepls CA, Gregor RT, Davidge-Pitts NJ, Waner M. The versatility of the pectoralia major myocutaneoua flap. Head Neck Surg. 1985;7:365-8.
10. Mehrhof, A.l. Jr., Rosenstock, A., Neifeld, J.P., Merritt, W.H., Theogaraj, S.D. and Cohen, L.K. The pectoralis major myocutaneous flap in head and neck reconstruction. Analy- sia of complications. Am.J.Surg., 1983;146:478-82.
11. Ariyan S. Reconstruction of the oropharyngeal area, in can- cer of the head and neck.(Eds.): S. Ariyan, St. Louis and CV Mosby. 1987:285-98.
12. McLean JN, Carlson GW, Losken A. The pectoralis major myocutaneous flap revisited: a reliable technique for head and neck reconstruction. Annals of plastic surgery. 2010May 1;64(5):570-3.
13. Milenović A, Virag M, Uglešić V, Aljinović-Ratković N.The pectoralis major flap in head and neck reconstruction:
first 500 patients. Journal of Cranio-Maxillofacial Surgery.2006 Sep 1;34(6):340-3.
14. Kekatpure VD, Trivedi NP, Manjula BV, et al. Pectoralis major flap for head and neck reconstruction in era of free flaps. Int J Oral Maxillofac Surg 2012;41:453-7. 4
15. Pinto FR, Malena CR, Vanni CM, Capelli FD, Matos LL, Kanda JL. Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of com- plications and the final outcome. Sao Paulo Medical Journal.
16. Dedivitis RA, Guimarães AV. Pectoralis major musculocu- taneous flap in head and neck cancer reconstruction. World journal of surgery. 2002;26(1):67.
17. Mehta S, Sarkar S, Kavarana N, Bhathena H, Mehta A. Com- plications of the pectoralis major myocutaneous flap in the oral cavity: a prospective evaluation of 220 cases. Plastic and reconstructive surgery. 1996 Jul;98(1):31-7.
2. Ariyan S. Further experiences with the pectoralis major my- ocutaneous flap for the immediate repair of defects from ex- cisions of head and neck cancers. Plastic and Reconstructive Surgery. 1979 Nov;64(5):605-12.
3. Baek SM, Lawson W, Biller HF. An analysis of 133 pec- toralis major myocutaneous flaps. Plastic and reconstructive surgery. 1982 Mar;69(3):460-9.
4. Ossoff RH, Wurster CF, Berktold RE, Krespi YP, Sisson GA. Complications after pectoralis major myocutaneous flap reconstruction of head and neck defects. Archives of Otolar- yngology. 1983 Dec 1;109(12):812-4.
5. Friedrich W, Lierse W, Herberhold C. Myocutaneous vas- cular territory of the thoracoacromial artery. A topograph- ical and morphometric study of the arterial vascularization of the pectoralis major myocutaneous flap. Acta anatomica.
1988;131(4):284-91.
6. Wilson JS, Ylacoumettis AM, O’Neill T. Some observations on 112 pectoralis major myocutaneous flaps. The American journal of surgery. 1984 Feb 1;147(2):273-9.
7. Brusati R, Collini M, Bozzetti A, Chiapasco M, Galioto S.The pectoralis major myocutaneous flap: Experience in 100 consecutive cases. Journal of Cranio-Maxillofacial Surgery.
1988 Jan 1;16:35-9.
8. Robertson MS, Allison RS. The pectoralis major muscle in head and neck reconstruction. Australian and New Zealand Journal of Surgery. 1986 Oct;56(10):753-7.
9. Josepls CA, Gregor RT, Davidge-Pitts NJ, Waner M. The versatility of the pectoralia major myocutaneoua flap. Head Neck Surg. 1985;7:365-8.
10. Mehrhof, A.l. Jr., Rosenstock, A., Neifeld, J.P., Merritt, W.H., Theogaraj, S.D. and Cohen, L.K. The pectoralis major myocutaneous flap in head and neck reconstruction. Analy- sia of complications. Am.J.Surg., 1983;146:478-82.
11. Ariyan S. Reconstruction of the oropharyngeal area, in can- cer of the head and neck.(Eds.): S. Ariyan, St. Louis and CV Mosby. 1987:285-98.
12. McLean JN, Carlson GW, Losken A. The pectoralis major myocutaneous flap revisited: a reliable technique for head and neck reconstruction. Annals of plastic surgery. 2010May 1;64(5):570-3.
13. Milenović A, Virag M, Uglešić V, Aljinović-Ratković N.The pectoralis major flap in head and neck reconstruction:
first 500 patients. Journal of Cranio-Maxillofacial Surgery.2006 Sep 1;34(6):340-3.
14. Kekatpure VD, Trivedi NP, Manjula BV, et al. Pectoralis major flap for head and neck reconstruction in era of free flaps. Int J Oral Maxillofac Surg 2012;41:453-7. 4
15. Pinto FR, Malena CR, Vanni CM, Capelli FD, Matos LL, Kanda JL. Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of com- plications and the final outcome. Sao Paulo Medical Journal.
16. Dedivitis RA, Guimarães AV. Pectoralis major musculocu- taneous flap in head and neck cancer reconstruction. World journal of surgery. 2002;26(1):67.
17. Mehta S, Sarkar S, Kavarana N, Bhathena H, Mehta A. Com- plications of the pectoralis major myocutaneous flap in the oral cavity: a prospective evaluation of 220 cases. Plastic and reconstructive surgery. 1996 Jul;98(1):31-7.
| Files | ||
| Issue | Vol 11 No 2 (2019) | |
| Section | Original Articles | |
| DOI | https://doi.org/10.18502/bccr.v11i2.1657 | |
| Keywords | ||
| Pectoral Major Myocutaneous Flap Deltopectoral flap Reconstruction Oral cancer | ||
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Davudov MM, Harirchi I, Mirzajani Z. Pectoralis Major Myocutaneous Flap Reconstruction with Deltopectoral Flap Incision in the Surgical Treatment of Oral Cancer. Basic Clin Cancer Res. 2019;11(2):96-102.
