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Erschienen in: European Archives of Oto-Rhino-Laryngology 11/2010

01.11.2010 | Head and Neck

The changing role of pectoralis major flap in head and neck reconstruction

verfasst von: Hin-Lun Liu, Jimmy Yu-Wai Chan, William Ignace Wei

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 11/2010

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Abstract

Although pectoralis major flap (PM flap) has been used as the workhorse flap in head and neck reconstruction, its use in head and neck defects seems to fall out of favour in the era of free tissue transfer. The aim of this review is to find out the role of PM flap in modern head and neck surgery. Medical records of patients who underwent PM flap reconstruction for head and neck defect in our division were reviewed. The age, gender, flap type, indication and complication rate were described. Between January 1998 and December 2008, 202 PM flaps were used for head and neck reconstruction in 192 patients. In the early study period (1998–June 2003), out of the 119 PM flap reconstructions, 106 (89%) were performed for immediate reconstruction after resection of head and neck tumour, while 10 (8%) were performed as salvage procedures for complication after tumour resection e.g. failure of free flap, pharyngocutaneous fistula. In the late study period (July 2003–2008), out of the 83 PM flap reconstructions, 58 (70%) were performed for immediate reconstruction, while 24 (29%) were performed as salvage procedures. For immediate reconstruction after tumour extirpation, 51 flaps (48%) were performed for reconstruction of the tongue in the early study period, while only 14 (24%) were performed in the late study period. The number of PM flap used for immediate reconstruction for other head and neck defects remained relatively static throughout the two study periods. Over the study period, there were 10 (5%) cases of partial flap necrosis and 2 (1%) total flap loss, making the overall flap necrosis rate 6%. In the era of free tissue transfer, the role of PM flap in head and neck surgery has shifted from immediate reconstruction to salvage operation. However, PM flap still has an unique role in the repair of certain head and neck defects.
Literatur
1.
Zurück zum Zitat Ariyan S (1979) The pectoralis major myocutaneous flap: a versatile flap for reconstruction in the head and neck. Plast Reconstr Surg 63:73–81CrossRefPubMed Ariyan S (1979) The pectoralis major myocutaneous flap: a versatile flap for reconstruction in the head and neck. Plast Reconstr Surg 63:73–81CrossRefPubMed
2.
Zurück zum Zitat Kroll SS, Goepfert H, Jones M, Guillamondegui O, Schusterman M (1990) Analysis of complications in 168 pectoralis major myocutaneous flaps used for head and neck reconstruction. Ann Plast Surg 25:93–97CrossRefPubMed Kroll SS, Goepfert H, Jones M, Guillamondegui O, Schusterman M (1990) Analysis of complications in 168 pectoralis major myocutaneous flaps used for head and neck reconstruction. Ann Plast Surg 25:93–97CrossRefPubMed
3.
Zurück zum Zitat Zbar RI, Funk GF, McCulloch TM, Graham SM, Hoffman HT (1997) Pectoralis major myofascial flap: a valuable tool in contemporary head and neck reconstruction. Head Neck 19:412–418CrossRefPubMed Zbar RI, Funk GF, McCulloch TM, Graham SM, Hoffman HT (1997) Pectoralis major myofascial flap: a valuable tool in contemporary head and neck reconstruction. Head Neck 19:412–418CrossRefPubMed
4.
Zurück zum Zitat Mehta S, Sarkar S, Kavarana N, Bhathena H, Mehta A (1996) Complications of the pectoralis major myocutaneous flap in the oral cavity: a prospective evaluation of 220 cases. Plast Reconstr Surg 98:31–37CrossRefPubMed Mehta S, Sarkar S, Kavarana N, Bhathena H, Mehta A (1996) Complications of the pectoralis major myocutaneous flap in the oral cavity: a prospective evaluation of 220 cases. Plast Reconstr Surg 98:31–37CrossRefPubMed
5.
Zurück zum Zitat Bertino G, Spasiano R, Mazzola I, Benazzo M (2005) The use of pedicled and free flaps in laryngeal cancer recurrences: postoperative considerations and functional results. Ann Plast Surg 55:384–388CrossRefPubMed Bertino G, Spasiano R, Mazzola I, Benazzo M (2005) The use of pedicled and free flaps in laryngeal cancer recurrences: postoperative considerations and functional results. Ann Plast Surg 55:384–388CrossRefPubMed
6.
Zurück zum Zitat de Bree R, Reith R, Quak JJ, Uyl-de Groot CA, van Agthoven M, Leemans CR (2007) Free radial forearm flap versus pectoralis major myocutaneous flap reconstruction of oral and oropharyngeal defects: a cost analysis. Clin Otolaryngol 32:275–282CrossRefPubMed de Bree R, Reith R, Quak JJ, Uyl-de Groot CA, van Agthoven M, Leemans CR (2007) Free radial forearm flap versus pectoralis major myocutaneous flap reconstruction of oral and oropharyngeal defects: a cost analysis. Clin Otolaryngol 32:275–282CrossRefPubMed
7.
Zurück zum Zitat Su WF, Hsia YJ, Chang YC, Chen SG, Sheng H (2003) Functional comparison after reconstruction with a radial forearm free flap or a pectoralis major flap for cancer of the tongue. Otolaryngol Head Neck Surg 128:412–418CrossRefPubMed Su WF, Hsia YJ, Chang YC, Chen SG, Sheng H (2003) Functional comparison after reconstruction with a radial forearm free flap or a pectoralis major flap for cancer of the tongue. Otolaryngol Head Neck Surg 128:412–418CrossRefPubMed
8.
Zurück zum Zitat Wong RK, Poon ES, Woo CY, Chan SC, Wong ES, Chu AW (2007) Speech outcomes in Cantonese patients after glossectomy. Head Neck 29:758–764CrossRefPubMed Wong RK, Poon ES, Woo CY, Chan SC, Wong ES, Chu AW (2007) Speech outcomes in Cantonese patients after glossectomy. Head Neck 29:758–764CrossRefPubMed
Metadaten
Titel
The changing role of pectoralis major flap in head and neck reconstruction
verfasst von
Hin-Lun Liu
Jimmy Yu-Wai Chan
William Ignace Wei
Publikationsdatum
01.11.2010
Verlag
Springer-Verlag
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 11/2010
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-010-1271-6

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