51 Microvascular and Regional Flaps in Head and Neck Reconstruction

Abstract

The pectoralis major musculocutaneous flap was first described in 1968 in the resurfacing of an anterior chest wall defect, though its first use in head and neck reconstruction was not until 1979. 3,4,5 Since then it has become one of the most utilized and reliable flaps for head and neck reconstruction. It can be used to reconstruct defects of the oral cavity, the oropharynx, the face, and the neck.The pectoralis major musculocutaneous flap can be easily raised as a myofascial or myocutaneous flap. It is known to be reliable, providing excellent bulk in a single stage for a variety of instances such as great vessel coverage, pharyngeal reconstruction, fistula closure, and salvage operations. The primary limitation of the flap is the bulkiness of the subcutaneous adipose tissue between the skin and the muscle. This can be reduced by stripping the skin and adipose and applying a skin graft to the surface of the muscle.Downloaded by: California Institute of Technology (CALTECH). Copyrighted material.