Role of Pectoralis Major Myocutaneous Flap in Laryngectomy Surgery: Single Surgeon Experience

Purpose: The purpose was to explore the application effect of anterolateral thigh perforator flap (ALTP) and pectoralis major myocutaneous flap on repairing the tissuedefects after oral cancer surgery. Methods: 100 oral cancer patients treated in our hospital from January 2018 to December 2020 were selected as the research objects. After both groups of patients received extended resection of tumors, neck lymph node dissection and other routine treatment, the control group was repaired by pectoralis major myocutaneous flap while the study group was repaired by ALTP to compare the flap survival rate, language, masticatory function and other related indicators between the two groups. Results: The flap harvesting time and defect repair time in the control group were shorter than those in the study group (P<0.05); The language, masticatory function and swallowing function in both groups after treatment were significantly better than those before treatment (P<0.05); The total incidence of complications in the study group was significantly lower than that in the control group (P<0.05); After treatment, the quality of life scores in both groups were significantly higher than those before treatment (P<0.05). Conclusion: Both ALTP and pectoralis major myocutaneous flap can be used to repair the tissue defects after radical resection of oral cancer, which can effective improve the postoperative appearance, language and masticatory function of oral cancer patients. However, pectoralis major myocutaneous flap has easier operation and shorter operation time while ALTP can significantly reduce the incidence of postoperative complications with higher safety.

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

The Scientific World JOURNAL ◽

10.1100/2012/384179 ◽

2012 ◽

Vol 2012 ◽

pp. 1-7 ◽

Cited By ~ 5

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.

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