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Inicio Acta Otorrinolaringológica Española Analysis of the efficacy of the pectoralis major myocutaneous flap in reconstruc...
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Vol. 73. Issue 3.
Pages 151-156 (May - June 2022)
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Vol. 73. Issue 3.
Pages 151-156 (May - June 2022)
Original article
Analysis of the efficacy of the pectoralis major myocutaneous flap in reconstructive head and neck surgery
Análisis de la eficacia del colgajo miocutáneo de pectoral mayor en cirugías reconstructivas de cabeza y cuello
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Arun Parkash Sharma, Junaid Malik, Seema Monga
Corresponding author
dr.seema.monga@gmail.com

Corresponding author.
, Shamsheer Alam, Shahid Rasool, Deepti Agarwal, Sudhir Bahadur
Department of Otorhinolaryngology and Head & Neck Surgery, Hamdard Institute of Medical Sciences & Research and HAHC Hospital, Jamia Hamdard University, Hamdard Nagar, Delhi, India
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Tables (3)
Table 1. Clinical profile of the patients.
Table 2. Details of PMMF reconstruction complications.
Table 3. Complications other than related to flap.
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Abstract
Introduction

Although free flaps have been used predominantly in past decades for the soft tissue reconstruction of head and neck malignancies, Pectoralis major myocutaneous flap (PMMF) is still a reliable workhorse for patients with co-existing co-morbidities or low economic status where free flaps are not feasible.

Patients and methods

It was a retrospective study done on 36 patients of head and neck malignancies over the period of 5 years in which PMMF was used as a method of reconstruction in our hospital. Patients were followed up for a period of one year and outcome of PMMF was evaluated.

Results

Out of 36 patients 31 were of oral cancer and 5 were of carcinoma hypopharynx. Incidence of total flap necrosis was nil and partial flap necrosis was 16.6%. Orocutaneous fistula was found in 16.6%, wound dehiscence was in 19.4% and infection was found in 13.5% of patients. Non-flap related complications were found in 13.8% of patients. 35 out of 36 patients (97.2%) eventually achieved satisfactory surgical outcome of PMMF reconstruction.

Conclusion

PMMF is a reliable method of reconstruction for head and neck malignancies especially in basic healthcare settings. With minimal expertise and groundwork, it is still a cost-effective workhorse flap for head and neck reconstruction.

Keywords:
Oral cancer
Pectoralis major myocutaneous flap
Head & neck reconstruction
Abbreviations:
PMMF
Resumen
Introducción

Aunque se han utilizado colgajos libres, fundamentalmente en las últimas décadas, para la reconstrucción de tejido blando en tumores malignos de cabeza y cuello, el colgajo miocutáneo de pectoral mayor (PMMF) sigue siendo un método fidedigno para los pacientes con comorbilidades coexistentes o baja situación económica en la que no se tiene acceso a los colgajos libres.

Pacientes y métodos

Estudio retrospectivo realizado en 36 pacientes con tumores malignos de cabeza y cuello a lo largo de un periodo de 5 años, en los que se utilizó PMMF como método de reconstrucción en nuestro hospital. Se realizó un seguimiento a los pacientes durante un periodo de un año, evaluándose el resultado de PMMF.

Resultados

De los 36 pacientes, 31 tenían cáncer oral y 5 cáncer de hipofaringe. La incidencia de necrosis total del colgajo fue nula, y la de necrosis parcial fue del 16,6%. Se encontró fístula orocutánea en el 16,6% de los casos, dehiscencia de la herida en el 19,4% e infección en el 13,5% de los pacientes. Se encontraron complicaciones no relacionadas con el colgajo en un 13,8% de los pacientes. Treinta y cinco de los 36 pacientes (97,2%) lograron finalmente un resultado quirúrgico satisfactorio de reconstrucción con PMMF.

Conclusión

El PMMF es un método de reconstrucción fiable para los tumores malignos de cabeza y cuello, especialmente en los entornos sanitarios básicos. Con experiencia y base preparatoria mínimas sigue siendo un colgajo fiable para la reconstrucción de cabeza y cuello.

Palabras clave:
Cáncer oral
Colgajo miocutáneo de pectoral mayor
Reconstrucción de cabeza y cuello

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