Comparison of outcomes with extensive segmental pectoralis major myocutaneous flap via the anterior axillary line and the conventional technique in oral and oropharyngeal cancer

Head Neck. 2018 Feb;40(2):349-354. doi: 10.1002/hed.24959. Epub 2017 Sep 30.

Abstract

Background: This study compared the outcomes of an extensive segmental pectoralis major myocutaneous flap (esPMMF) and a conventional pectoralis major myocutaneous flap (PMMF).

Methods: The study enrolled 91 patients with primary oral and oropharyngeal squamous cell carcinoma (SCC) who underwent radical resection followed by reconstruction of the defect using either an esPMMF via the anterior axillary line or a PMMF. The pedicle lengths of the esPMMF and PMMF were 22-28 and 18-22 cm, respectively. The esPMMF and PMMF had skin paddle dimensions of 5 × 8 to 7 × 14 cm and 6 × 7 to 8 × 17 cm, respectively.

Results: The esPMMF pedicle was longer than that of the PMMF. The range of shoulder abduction was significantly greater in the esPMMF group and the donor-site aesthetic results were better.

Conclusion: The esPMMF has a longer pedicle flap, enables a greater range of shoulder abduction, and has a better aesthetic result than the conventional technique.

Keywords: oral cavity; oropharynx; pectoralis major flap; shoulder morbidity; squamous cell carcinoma.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Squamous Cell / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Mouth Neoplasms / surgery*
  • Myocutaneous Flap*
  • Oropharyngeal Neoplasms / surgery*
  • Pectoralis Muscles / transplantation*
  • Plastic Surgery Procedures / methods*
  • Range of Motion, Articular
  • Shoulder / pathology
  • Shoulder / physiology
  • Treatment Outcome