The Versatility of Pectoralis Major Myocutaneous Flap in Head and Neck Reconstruction

Abstract

Introduction:  Although different flaps can be used for facial reconstruction but Pectoralis major myocutaneous flap is still considered the workhorse for maxillofacial reconstruction because of simple procedure and high success rate, while other flaps of facial region ranging from pedicled to free flaps require greater surgical skills along with unpredictable results.

Objective:  To find outcomes of Pectoralis major myocutaneous flap in reconstruction of middle and lower facial regions. Main outcome measures are vitality of the Pectoralis major myocutaneous flap, donor site morbidity and other complications.

Study design:  Descriptive study.

Place and duration of study:  Department of Oral & Maxillofacial Surgery, King Edward Medical University/ Mayo hospital Lahore, from April 2005 to June 2006.

Patients and methods:  This study was carried out on 30 consecutive patients who require soft tissue reconstruction of middle and lower facial regions. Vitality of Pectoralis major myocutaneous flap, donor site morbidity and other complica-tions were studied.

Results:  In this study, the success rate of was 100%. All of the flaps were vital but 13.3% of the flaps had partial loss of flap.

Conclusion:  Pectoralis major myocutaneous flap is a versatile flap as it can not only provide skin and mucosal cover simultaneously, but also provide adequate muscle bulk for through and through defects. It doesn’t cause any hindrance in mandibular movements, even when used over mandibular reconstruction plate.

Keywords:  Oral Reconstruction, Pectoralis major muscle, Myocutaneous flap, Axial pattern flap.