Delayed Pharyngoesophageal Reconstruction with Combined Local and Regional Flaps: A Case Report

Pinto, Fábio Roberto; Kanda, Jossi Ledo

doi:10.1177/014556131109000319

Cited by 4 publications

(5 citation statements)

References 16 publications

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“…Recently microvascular free flaps are considered the gold standard method for reconstruction of major defects following head and neck cancer surgery [12]. In the era of microsurgical free flaps, pedicled flaps still hold their position for the reconstruction of oral cavity cancers [13]. Study conducted by Pancholi M et al have shown PMMC flap to be easy, done early and adds to the bulk of reconstructed tissue thereby maintaining the contour especially in full thickness cheek defects post hemimandibulectomy or maxillectomy where a radial forearm flap will leave a distinct hollow due to lack of bulk [14].…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Pectoralis Major Myocutaneous Flap in the Reconstruction of Head and Neck

Kallappa¹,

Mijar²

2020

IJCOCR

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Pectoralis major myocutaneous (PMMC) flap is versatile flap used for reconstruction of various head and neck defects created after excision of tumors. Due to the rapid advancement of reconstructive microsurgery, micro vascularised free flap transfer is becoming the main method of head and neck reconstruction. Presently PMMC flap reconstruction is used as an option for salvage surgery post free flap transfer failure and also in patients who are poor candidates for free flap transfer. However in developing countries like India where there are limited resources and the patient's presents in advanced stage of the disease PMMC flap is a viable option for reconstruction. Aim is to study the outcome of PMMC flap reconstruction in head and neck malignancy. A prospective analysis was done with 20 patients who underwent wide local excision with marginal or hemi mandibulectomy with PMMC flap reconstruction and neck dissection from January 2017 to January 2019 in tertiary care center. Follow up was done for every 2 weeks for first 2 months, then every month for a period of 6 months. Out of all the patients who underwent PMMC flap reconstruction, 2 patients developed partial flap necrosis, 1 had wound dehiscence and fistula and 1 patient had local recurrence. For remaining patients no complications were noted in the follow up period.

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Section: Discussionmentioning

confidence: 99%

Outcomes of Pectoralis Major Myocutaneous Flap in the Reconstruction of Head and Neck

Kallappa¹,

Mijar²

2020

IJCOCR

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“…[ 7 ] However, recently microvascular free flaps are considered the gold standard method for reconstruction of major defects following head and neck cancer surgery. [ 8 ] In the era of microsurgical free flaps, pedicled flaps still hold their position for the reconstruction of oral cavity cancers,[ 9 ] especially we have found great advantage of using PMMC flap as it is easy, done early and adds to the bulk of reconstructed tissue thereby maintaining the contour especially in full thickness cheek defects posthemimandibulectomy or maxillectomy where a radial forearm flap will leave a distinct hollow due to lack of bulk.…”

Section: Discussionmentioning

confidence: 99%

Crossed pectoralis major myocutaneous flap for recurrent oral cavity cancers

Pancholi

Sharma

Desai

et al. 2016

Ann Maxillofac Surg

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Background:Oral cavity cancers are fairly common and have propensity to recur locally. Since Pectoralis Major Myocutaneous (PMMC) flap is the most widely used first flap for reconstruction, it is exhausted at the earliest and recurrence poses a formidable challenge for reconstructive surgeon. Present study evaluated the feasibility of contralateral Pectoralis Major Myocutaneous Flap for reconstruction after resection of recurrent tumour.Methods:This was a study of the patients presenting with recurrent oral cavity cancer after exhausted ipsilateral Pectoralis Major Myocutaneous Flap (PMMC) in whom we used contralateral Pectoralis Major Myocutaneous Flap (Crossed PMMC Flap) for reconstruction between October 2013 to June 2016.Results:Five patients with recurrence underwent reconstruction with contralateral Pectoralis Major Myocutaneous Flap. In all the flap was successfully used to reconstruct defects involving the entire buccal mucosa and in one patient the flap could be used to reconstruct full thickness resection defect(crossed bipedal PMMC Flap) with ease.Conclusion:Crossed Pectoralis Major Myocutaneous Flap can be used safely and reliably for reconstruction of the buccal mucosal defect and in selected patients even for full thickness cheek defect as folded bipaddle Pectoralis Major Myocutaneous Flap.

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“…Despite recent advances in microsurgical techniques, pedicled flaps are still an acceptable option for the reconstruction of complex defects of the head and neck, especially intraoral defects and those of the hypopharynx and skin [ 8 ]. Various types of treatment for the relapse of head and neck cancer have been studied and discussed, mainly emphasizing radical resection and immediate reconstruction.…”

Section: Discussionmentioning

confidence: 99%

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

Vanni

Matos

Faro

et al. 2012

The Scientific World Journal

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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 (P = 0.013) as well as in patients submitted to surgery in association with radiation therapy as a previous cancer treatment (P = 0.002). The former condition is also associated with major reconstruction failure (P = 0.018). An even lower incidence of major complications was noted in patients under the age of 53 (P = 0.044). 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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Delayed Pharyngoesophageal Reconstruction with Combined Local and Regional Flaps: A Case Report

Cited by 4 publications

References 16 publications

Outcomes of Pectoralis Major Myocutaneous Flap in the Reconstruction of Head and Neck

Outcomes of Pectoralis Major Myocutaneous Flap in the Reconstruction of Head and Neck

Crossed pectoralis major myocutaneous flap for recurrent oral cavity cancers

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

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