Pectoralis major musculocutaneous flap in head and neck cancer reconstruction

Abstract

Described initially by Ariyan in the 1970s, the pectoralis major flap has broad acceptance for its versatility in head and neck cancer reconstructions. It is supplied by the thoracoacromial artery, with an additional circulation provided by the lateral thoracic artery. It can be safely used even in patients who have undergone postoperative radiation. The objective of this work is to analyze retrospectively the indications and results of this reconstruction technique in 17 patients with head and neck cancer. We have selected the pectoralis major flap for reconstruction of floor of the mouth and tongue (7 patients); pharyngoesophageal transit after pharyngolaryngectomy (7 patients); facial tissue repair after parotid cancer excision and reconstruction of the soft part of cervical area after skin excision during cervical dissection. Total necrosis of the flap for pharyngoesophageal reconstruction was observed in one patient. Partial loss of the skin flap with partial dehiscence occurred in four patients underwent tongue and floor of the mouth repair, but without fistulae and infection. There was donor site seroma in one patient. The flap was functionally adequate both in the reconstruction of the neopharynx and for repair of great surgical defects. So it is a versatile method with good functional results.