VARIATIONS AND MODIFICATIONS OF FAR-FAMED PECTORALIS MAJOR FLAP: A REVIEW OF LITERATURE

The pectoralis major flap is undoubtedly a workhorse flap in the field of head and neck oncology even with the advent of free flaps. Lack of expertise and resources limits the use of free flap and still makes pectoralis major flap widely chosen. Head and neck cancer in advanced stage requires extensive resection entailing reconstruction of various sized defects which is possible only with a versatile flap. This flap is also a salvage flap when all the other options failed, since four decades. The purpose of this article is to highlight variations and modifications related to pectoralis major flap in head and neck reconstructive procedures. For this a thorough literature search was done using Medline and PubMed databases. Non-English language papers were excluded from the review. A total of 50 articles were obtained through verification of the title and abstract. Considering the relevance of the matter 32 articles were opted for the present review.

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Pectoralis major flap for head and neck reconstruction in era of free flaps

International Journal of Oral and Maxillofacial Surgery ◽

10.1016/j.ijom.2011.12.029 ◽

2012 ◽

Vol 41 (4) ◽

pp. 453-457 ◽

Cited By ~ 20

Author(s):

V.D. Kekatpure ◽

N.P. Trivedi ◽

B.V. Manjula ◽

A. Mathan Mohan ◽

G. Shetkar ◽

...

Keyword(s):

Head And Neck ◽

Free Flaps ◽

Pectoralis Major ◽

Head And Neck Reconstruction ◽

Pectoralis Major Flap ◽

Neck Reconstruction

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The Extended Pectoralis Major Flap in Head and Neck Reconstruction

Otolaryngology ◽

10.1177/019459988609400302 ◽

1986 ◽

Vol 94 (3) ◽

pp. 274-278 ◽

Cited By ~ 2

Author(s):

Clarence T. Sasaki ◽

Linda J. Gardiner ◽

Roy D. Carlson ◽

Thomas Vris

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Pectoralis Major ◽

Head And Neck Reconstruction ◽

Pectoralis Major Flap ◽

Reconstructive Procedures ◽

Musculocutaneous Flaps ◽

Neck Reconstruction ◽

Reconstructive Techniques

Historically, major extirpative surgery for control of head and neck cancer developed well in advance of reconstructive procedures that could provide acceptable functional and cosmetic rehabilitation. Introduction of cutaneous axial and random flaps— followed more recently by the description of musculocutaneous flaps—represented major advances in reconstructive techniques.

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Pectoralis Major Flap for Head and Neck Reconstruction

Operative Dictations in Plastic and Reconstructive Surgery ◽

10.1007/978-3-319-40631-2_87 ◽

2016 ◽

pp. 365-368

Author(s):

Stephan Ariyan

Keyword(s):

Head And Neck ◽

Pectoralis Major ◽

Head And Neck Reconstruction ◽

Pectoralis Major Flap ◽

Neck Reconstruction

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Surgical Configurations of the Pectoralis Major flap for Reconstruction of Sternoclavicular Defects: A Systematic Review and New Classification of Described Techniques

10.21203/rs.2.11054/v1 ◽

2019 ◽

Author(s):

Jude Opoku-Agyeman ◽

David Matera ◽

Jamee Simone

Keyword(s):

Classification System ◽

English Language ◽

Pectoralis Major ◽

Cochrane Library ◽

New Classification ◽

Pectoralis Major Flap ◽

Defect Reconstruction ◽

Type 3

Abstract Objectives The pectoralis major flap has been considered the workhorse flap for chest and sternoclavicular defect reconstruction. There have been many configurations of the pectoralis major flap reported in the literature for use in reconstruction sternoclavicular defects either involving bone, soft tissue elements, or both. This study reviews the different configurations of the pectoralis major flap for sternoclavicular defect reconstruction and provides the first ever classification for these techniques. Methods EMBASE, Cochrane library, Ovid medicine and PubMed databases were searched from its inception to November of 2018. We included all studies describing surgical management of sternoclavicular defects. The studies were reviewed, and the different configurations of the pectoralis major flap used for sternoclavicular defect reconstruction were cataloged. We then proposed a new classification system for these procedures. Results The study included 5 articles published in the English language that provided a descriptive procedure for the use of pectoralis major flap in the reconstruction of sternoclavicular defects. The procedures were classified into three broad categories. In Type 1, the whole pectoris muscle is used. In Type 2, the pectoralis muscle is split and either advanced medially (type 2a) or rotated (type 2b) to fill the defect. In type 3, the clavicular portion of the pectoralis is islandized on a pedicle, either the TAA (type 3a) or the deltoid branch of the TAA (type 3b). Conclusion There are multiple configurations of the pectoralis flap reported in the English language literature for the reconstruction of sternoclavicular defects. Our classification system will help facilitate communication when describing the different configurations of the pectoralis major flap for reconstruction of sternoclavicular joint defects.

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