scholarly journals Enhanced Morbidity of Pectoralis Major Myocutaneous Flap Used for Salvage after Previously Failed Oncological Treatment and Unsuccessful Reconstructive Head and Neck Surgery

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Christiana Maria Ribeiro Salles Vanni ◽  
Leandro Luongo de Matos ◽  
Mário Paulo Faro Junior ◽  
Jossi Ledo Kanda ◽  
Cláudio Roberto Cernea ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck ◽  
Myocutaneous Flap ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Pectoralis Major ◽  
Pectoralis Major Myocutaneous Flap ◽  
Cross Sectional ◽  
Oncological Treatment ◽  
Major Complications

Introduction. The reconstruction of complex cervicofacial defects arising from surgical treatment for cancer is a real challenge for head and neck surgeons, especially in salvage reconstruction surgery and/or failed previous reconstruction. The pectoralis major myocutaneous flap (PMMF) has been widely used in these specific situations due to its reliability and low rate of failure or complications.Objectives. Identify factors that determine complications and influence the final outcome of the reconstructions with PMMF in salvage cancer surgery or in salvage reconstruction.Methods. A cross-sectional study design was used to evaluate a sample including 17 surgical patients treated over a period of ten years that met the inclusion criteria.Results. Reconstruction was successful in 13 cases (76.5%), with two cases of partial flap loss and no case of total loss. Complications occurred in 13 cases (76.5%) and were specifically related to the flap in nine instances (52.9%). An association was identified between the development of major complications and reconstruction of the hypopharynx () as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (). The former condition is also associated with major reconstruction failure (). An even lower incidence of major complications was noted in patients under the age of 53 ().Conclusion. Older patients, with hypopharyngeal defects and submitted to previous surgery plus radiation therapy, presented a higher risk of complications and reconstruction failure with PMMF.

scholarly journals Pectoralis major myocutaneous flaps for head and neck reconstruction: factors influencing occurrences of complications and the final outcome

2010 ◽  
Vol 128 (6) ◽  
pp. 336-341 ◽  
Author(s):  
Fábio Roberto Pinto ◽  
Carina Rosa Malena ◽  
Christiana Maria Ribeiro Salles Vanni ◽  
Fábio de Aquino Capelli ◽  
Leandro Luongo de Matos ◽  
...  
Keyword(s):  
Head And Neck ◽  
Cross Sectional Study ◽  
Pectoralis Major ◽  
Disease Stage ◽  
Head And Neck Reconstruction ◽  
Cross Sectional ◽  
Myocutaneous Flaps ◽  
Oncological Treatment ◽  
Patients Âgés ◽  
Major Complications

CONTEXT AND OBJECTIVE: Pedicled flaps play an important role in cancer treatment centers, particularly in developing and emerging countries. The aim of this study was to identify factors that may cause complications and influence the final result from reconstructions using pectoralis major myocutaneous flaps (PMMFs) for head and neck defect repair following cancer resection. DESIGN AND SETTING: Cross-sectional study at the Hospital de Ensino Padre Anchieta of Faculdade de Medicina do ABC (FMABC). METHODS: Data on 58 patients who underwent head and neck defect reconstruction using PMMFs were reviewed. The final result from the reconstruction (success or failure) and the complications observed were evaluated in relation to the patients' ages, area reconstructed, disease stage, previous oncological treatment and need for blood transfusion. RESULTS: There were no total flap losses. The reconstruction success rate was 93.1%. Flap-related complications occurred in 43.1% of the cases, and half of them were considered major. Most of the complications were successfully treated. Defects originating in the hypopharynx were correlated with the development of major complications (p = 0.02) and with reconstruction failure (p < 0.001). Previous oncological treatment negatively influenced the reconstruction success (p = 0.04). CONCLUSIONS: Since the risk factors for developing major complications and reconstruction failure are known, it is important to heed the technical details and provide careful clinical support for patients in a more critical condition, so that better results from using PMMFs can be obtained.

scholarly journals Readability of the American, Canadian, and British Otolaryngology–Head and Neck Surgery Societies’ Patient Materials

2021 ◽  
pp. 019459982110332
Author(s):  
Joo Hyun Kim ◽  
Elysia Grose ◽  
Justine Philteos ◽  
David Forner ◽  
Christopher W. Noel ◽  
...  
Keyword(s):  
Patient Education ◽  
Head And Neck ◽  
Grade Level ◽  
Neck Surgery ◽  
Cross Sectional Study ◽  
Reading Level ◽  
Head And Neck Surgery ◽  
Cross Sectional ◽  
Patient Comprehension ◽  
Reading Grade Level

Objective Patient education materials across 3 national English otolaryngology–head and neck surgery (OHNS) societies: the American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS), the Canadian Society of Otolaryngology–Head and Neck Surgery (CSOHNS), and Ear, Nose, and Throat United Kingdom (ENT UK) were examined to determine whether they are written at a level suitable for patient comprehension. Study Design Cross-sectional study. Setting Online patient materials presented through OHNS national societies. Methods Readability was calculated using the Flesch-Kincaid Grade Level, Flesch-Kincaid Reading Ease Score, and Simple Measure of Gobbledygook Index. All public patient education materials available through the CSOHNS, AAO-HNS, and ENT UK websites were assessed. Patient education materials were grouped into categories by subspecialty. Results In total, 128 patient materials from the 3 societies were included in the study. All 3 societies required a minimum grade 9 reading comprehension level to understand their online materials. According to Flesch-Kincaid Grade Level, the CSOHNS required a significantly higher reading grade level to comprehend the materials presented when compared to AAO-HNS (11.3 vs 9.9; 95% CI, 0.5-2.4; P < .01) and ENT UK (11.3 vs 9.4; 95% CI, 0.9-2.9; P < .01). Patient education materials related to rhinology were the least readable among all 3 societies. Conclusion This study suggests that the reading level of the current patient materials presented through 3 national OHNS societies are written at a level that exceeds current recommendations. Promisingly, it highlights an improvement for the readability of patient materials presented through the AAO-HNS.

COMPLEX OROFACIAL DEFECTS -A RECONSTRUCTIVE CHALLENGE

2013 ◽  
Vol 5 (2) ◽  
pp. 56-63
Author(s):  
Rajay A. D. Kamath ◽  
Shiva Bharani K. S. N. ◽  
S Shubha Lakshmi ◽  
Amith Hadhimane
Keyword(s):  
Oral Cavity ◽  
Head And Neck ◽  
Myocutaneous Flap ◽  
Donor Site ◽  
Primary Objective ◽  
Pectoralis Major ◽  
Pectoralis Major Myocutaneous Flap ◽  
Microvascular Reconstruction ◽  
Skin Paddle ◽  
Ablative Surgery

ABSTRACT Introduction Oral cavity cancers account for 30% of head and neck cancers and represent a significant challenge to clinicians. Treatment requires multi disciplinary expertise and is complicated by. the complex role that the oral cavity plays in speech, mastication, and swallowing. Surgery remains the cornerstone of most treatment regimens; the primary objective is cure, not withstanding preservation of form and function to retain a good quality of life that can be further improved by reconstructive techniques using various local flaps, distant flaps or microvascular reconstruction. The pectoralis major [PM] flap has many advantages in that it is very reliable, and allows a single-stage reconstruction of most head and neckdefects to the level of the maxilla with well-vascularized tissue capable of carrying a large skin paddle. The donor site morbidity is surprisingly low, and few patients complain of difficulties with arm movement. Aims & Objectives This paper revisits the surgical anatomy and technique of harvesting the Pectoralis Major myocutaneous flap used to reconstruct complex defects of the lower face following composite therapeutic resection. In addition, we describe our experience using this flap and discuss associated merits and demerits and complications. Conclusion Despite contemporary micro vascular techniques, the Pectoralis Major myocutaneous flap continues to be a versatile option in the reconstruction of complex head and neck defects following ablative surgery. However, regardless of the site, stage and degree of tumor differentiation, such cases will always pose as a therapeutic challenge to the reconstructive surgeon.

A Method that Preserves Circulation during Preparation of the Pectoralis Major Myocutaneous Flap in Head and Neck Reconstruction

1998 ◽  
Vol 102 (7) ◽  
pp. 2336-2345 ◽  
Author(s):  
Kensuke Kiyokawa ◽  
Yoshiaki Tai ◽  
Hiroko Yanaga Tanabe ◽  
Yojiro Inoue ◽  
Toshihiko Yamauchi ◽  
...  
Keyword(s):  
Head And Neck ◽  
Myocutaneous Flap ◽  
Pectoralis Major ◽  
Pectoralis Major Myocutaneous Flap ◽  
Head And Neck Reconstruction ◽  
Neck Reconstruction
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