Bipaddle Pectoralis Major Myocutaneous Flap for Single Stage Reconstruction of Oromandibular Defects

Sahu, Pankaj Kumar; Kumar, Satish

doi:10.1007/s12070-019-01731-w

Cited by 11 publications

(2 citation statements)

References 14 publications

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“…This is comparable with other large series of PMMC flap by various authors such as Pradhan et al .,[ 7 ] Ahmad GQ et al .,[ 8 ] Bhola et al . [ 9 ], Konduru et al .,[ 10 ] Sahu et al .,[ 11 ] Deo et al .,[ 12 ] Jacob et al .,[ 13 ] Tripathi et al .,[ 14 ] Chaturvedi et al . [ 15 ] and Mehta et al .…”

Section: Discussionmentioning

confidence: 99%

Mango-shaped Bi-paddled pectoralis major myocutaneous flap reconstruction for large full-thickness defects post resection of squamous cell carcinoma of oral cavity

Tilak

JF²,

Kumar³

et al. 2022

National Journal of Maxillofacial Surgery

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Objectives: The objective of the study was to examine the feasibility of bi-paddled pectoralis major myocutaneous (PMMC) flap reconstruction in patient undergoing full thickness composite resection. Materials and Methods: Inclusion criteria: The subjects chosen were patients with clinically T4A squamous cell carcinoma of buccal mucosa, lower alveolus, and maxilla in with skin involvement. Patients required a full-thickness composite resection of intraoral lesion, bone (mandibular segment and/or maxilla), and overlying involved skin and had modified radical neck dissection. Exclusion criteria: Patients not requiring full thickness composite resection including skin. Patients were observed postoperatively for early and late postoperative complications, starting of oral feeding, post-operative trismus, and dysphagia during subsequent follow-up and cosmetic outcome. Results: Overall, the complication rate was 33.8% out of which only 7.8% required major re-surgery with second flap reconstruction. This is comparable with other large series of PMMC flap. Clavien-Dindo Grade I complications were seen in 9.5%, Grade II in 69.7%, Grade IIIA in 13.4%, and Grade IIIB in 7.45% of patients. Full-thickness partial flap necrosis included necrosis of either the external or the internal skin paddle. There were 15 cases – 6.5% of full thickness external paddle necrosis. These were mostly in patients with bite composite resections and having a larger random fasciocutaneous distal component of the flap without underlying muscle. Furthermore, 40% of these patients were females. In females, the flap necrosis comprised 4 of the 12 patients (33.33%). Conclusion: Pectoralis major mycocutaneous flap has been a boon to reconstruction of the oral cavity post its inception. In case of locally advanced squamous cell carcinomas of the oral cavity, in many instances, there is a clinically significant cervical lymph nodal spread vessels post mandating a comprehensive lymph node dissection. PMMC flap provides a robust well vascularized muscular cover to the cervical vessels poststernocleidomastoid excision.

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Section: Discussionmentioning

confidence: 99%

Mango-shaped Bi-paddled pectoralis major myocutaneous flap reconstruction for large full-thickness defects post resection of squamous cell carcinoma of oral cavity

Tilak

JF²,

Kumar³

et al. 2022

National Journal of Maxillofacial Surgery

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“…Several free or pedicle flaps, such as radial forearm flap ( 8 ), latissimus dorsi flap ( 9 ), anterolateral thigh (ALT) flap ( 4 , 10 – 12 ), and pectoralis major flap ( 13 ), have been used to repair oral and maxillofacial soft-tissue defects. Among them, the ALT flap, which was first introduced in 1984 by Song et al.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of Complex Lateral Skull Base Defects After Oral Cancer Resection With Individualized Anterolateral Thigh Flap

et al. 2021

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ObjectivesComplex lateral skull base defects resulting from advanced or recurrent oral cancer resection are continuously challenging reconstructive surgeons. This study aimed to use reconstructive methods for lateral skull base defects, explore their feasibility, and evaluate the efficacy of defect reconstruction using anterolateral thigh (ALT) flaps.Patients and MethodsWe performed a retrospective case series of 37 patients who underwent lateral skull base defect reconstruction using the ALT/anteromedial thigh (AMT) flap between March 2016 and May 2021 at the Second Xiangya Hospital. The design and harvest of the flaps, methods for defect reconstruction, and reconstructive efficacy are described.ResultsOf the 37 patients, 3 were women and 34 were men, with a mean age of 51.7 years. Among the defects, 26 were through-and-through defects and were reconstructed using ALT chimeric flaps, double ALT flaps, folded ALT flap, combined ALT chimeric flaps and AMT flaps, or combined ALT chimeric flaps and pectoralis major flaps; the large lateral skull base dead spaces were filled with muscle tissues or fatty tissues. Postoperatively, 38 of the 39 ALT/AMT flaps survived completely, and the remaining flap experienced partial necrosis. Venous compromise occurred in one patient who was salvaged after operative exploration. Oral and maxillofacial wound infections occurred in two patients, salivary fistula in three patients, and thigh wound effusion in three patients. The wounds healed gradually in all patients after repeated dressing changes. Thirty-three patients were followed up for approximately 3–60 months; their oral functions and appearance were acceptable, and thigh motor dysfunction was not observed.ConclusionsWith the convenient flap design and muscle flap harvest, large and individualized tissue supply, feasible combination with other flaps, effective reduction or avoidance of wound complications, and acceptable donor site morbidity, the ALT flap is an appropriate choice for complex lateral skull base defect reconstruction.

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Pectoralis Major Myocutaneous Flap

Carlson¹,

Lee²

2022

Atlas of Operative Oral and Maxillofacial Surgery

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Bipaddle Pectoralis Major Myocutaneous Flap for Single Stage Reconstruction of Oromandibular Defects

Cited by 11 publications

References 14 publications

Mango-shaped Bi-paddled pectoralis major myocutaneous flap reconstruction for large full-thickness defects post resection of squamous cell carcinoma of oral cavity

Mango-shaped Bi-paddled pectoralis major myocutaneous flap reconstruction for large full-thickness defects post resection of squamous cell carcinoma of oral cavity

Reconstruction of Complex Lateral Skull Base Defects After Oral Cancer Resection With Individualized Anterolateral Thigh Flap

Pectoralis Major Myocutaneous Flap

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