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. 2014 Dec;66(4):414-7.
doi: 10.1007/s12070-014-0732-4. Epub 2014 Jun 4.

5th Rib Osteo-pectoralis Major Myocutaneous Flap-Still a Viable Option for Mandibular Defect Reconstruction

N Brian Shunyu  1 , Jayanta Medhi  1 , Hanifa Akhtar Laskar  1 , Nari Lyngdoh  2 , Judita Syiemlieh  3 , Amit Goyal  4
Affiliations

5th Rib Osteo-pectoralis Major Myocutaneous Flap-Still a Viable Option for Mandibular Defect Reconstruction

N Brian Shunyu et al. Indian J Otolaryngol Head Neck Surg. 2014 Dec.

Abstract

Reconstruction of mandible is of paramount importance following ablative surgery for oral cancer. Though osteocutaneous micro-vascular free flap is generally accepted to be the mainstay of mandibular reconstruction, other reconstructive options are also done for mandibular reconstruction with good results. Seventeen patients of oral cavity cancer involving the alveolus who had underwent hemi-mandibulectomy were reconstructed using 5th rib osteo-pectoralis major myocutaneous flap. Procedure related pleural tear occurred in 3 patients during harvesting of the rib which were repaired intra-operatively with no post-operative complications. There were 2 failures in our series, in the rest 15 patients the flap had taken up; have good oral continence taking semi-solid diet and have satisfactory cosmetic appearance. This study shows that 5th rib osteo-pectoralis major myocutaneous flap is a quick, easy to learn, one stage reconstructive procedure with a good predictable cosmetic and functional outcomes.

Keywords: Fifth rib osteo-pectoralis major myocutaneous flap; Hemi-mandibulectomy; Oral cancer.

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Figures

Fig. 1
Fig. 1
Intra-operative view of medial end of harvested rib with muscle and skin attached to it
Fig. 2
Fig. 2
a Intra-oral view of the flap. b External view of the patient
Fig. 3
Fig. 3
Skin incision
Fig. 4
Fig. 4
Intra-operative view of the rib been fixed to the opposite mandible
Fig. 5
Fig. 5
a Good alignment of the upper and lower jaw. b X-ray of the reconstructed mandible on the right side
See this image and copyright information in PMC

References

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