Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Feb 27:3:12.
doi: 10.1186/1758-3284-3-12.

Evaluation of the pectoralis major flap for reconstructive head and neck surgery

Astrid L Kruse  1 , Heinz T Luebbers, Joachim A Obwegeser, Marius Bredell, Klaus W Grätz
Affiliations

Evaluation of the pectoralis major flap for reconstructive head and neck surgery

Astrid L Kruse et al. Head Neck Oncol. .

Abstract

Purpose: The pectoralis major myocutaneous flap (PMMF) is a commonly used flap in reconstructive head and neck surgery, but in literature, the flap is also associated with a high incidence of complications in addition to its large bulk. The purpose of the study is the evaluation of the reliability and indication of this flap in reconstructive head and neck surgery.

Patients and methods: The records of all patients treated with a PMMF between 1998 and 2009 were systematically reviewed. Data of recipient localization, main indication, and postoperative complications were analyzed.

Results: The male to female ratio was 17:3, with a mean age of 60 years (45-85). Indications in 7 patients were recurrence of a squamous cell carcinoma, in one case an osteoradionecrosis and in 12 cases an untreated squamous cell carcinoma. In 6 male patients (30%), a complication appeared leading to another surgery.

Conclusion: The PMMF is a flap for huge defects in head and neck reconstructive surgery, in particular when a bulky flap is needed in order to cover the carotid artery or reconstructive surgery, but the complication rate should not be underestimated in particular after radiotherapy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Incision of the flap through the skin, subcutaneous fat and pectoralis fascia down to the chest wall.
Figure 2
Figure 2
Dissection of the flap off the chest wall.
Figure 3
Figure 3
Identification of the pedicel by visualization on the deep surface of the muscle.
Figure 4
Figure 4
Flap is being passed underneath the skin bridge.
Figure 5
Figure 5
Possibility of harvesting a deltopectoral and pectoralis major flap from the same side.
Figure 6
Figure 6
Distribution of primary T status.
Figure 7
Figure 7
Distribution of defect localizations covered with PMMF.
Figure 8
Figure 8
a Closure of the donor side defect with buttons b Closure of the donor side defect with Ventrofil®
See this image and copyright information in PMC

References

    1. Ariyan S. Further experiences with the pectoralis major myocutaneous flap for the immediate repair of defects from excisions of head and neck cancers. Plast Reconstr Surg. 1979;64:605–612. doi: 10.1097/00006534-197964050-00002. - DOI - PubMed
    1. Ariyan S. The pectoralis major myocutaneous flap. A versatile flap for reconstruction in the head and neck. Plast Reconstr Surg. 1979;63:73–81. doi: 10.1097/00006534-197901000-00012. - DOI - PubMed
    1. Dedivitis RA, Guimaraes AV. Pectoralis major musculocutaneous flap in head and neck cancer reconstruction. World J Surg. 2002;26:67–71. doi: 10.1007/s00268-001-0183-4. - DOI - PubMed
    1. El-Marakby HH. The reliability of pectoralis major myocutaneous flap in head and neck reconstruction. J Egypt Natl Canc Inst. 2006;18:41–50. - PubMed
    1. Ethier JL, Trites J, Taylor SM. Pectoralis major myofascial flap in head and neck reconstruction: indications and outcomes. J Otolaryngol Head Neck Surg. 2009;38:632–641. - PubMed