Pectoralis major rib osteomyo cutaneous flap in primary mandibular reconstruction in floor of the mouth cancer

Abstract

Key words P. M. rib Osteomyocutaneous flap, free graft, mandibular arch.Resection of mandible for floor of the mouth cancer results in predictable deformity depending on the extent of resection. Anterior segment resection results in medial rotation of both remaining segment combined with loss of support for the base of the tongue and hyoid bone. Such a defect results in a devastating functional and aesthetic deformity which so debilitating that primary reconstruction is mandatory. Reconstruction of composite defect is performed rig-iShowing the pre operative lesion in the floor of the mouth Fig-2Showing the marking of the flap with fifth rib with bone and soft tissue in one operation as far as possible to shorten the hospital stay.The reconstruction of bony part is always a challange. It may be plates, titanum trays, cortico cancellous grafts etc. These have high complication rate for extrusion and infection. By ~ontrast, vascularised bone graft like ( )steomyocut. and microvascular flaps allow for l~rimary healing of the graft as if it were a simple fracture (3). The recent popularity of free graft

Pedicled osteomyocutaneous pectoralis major flap with osseous rib harvest for salvage mandibular reconstruction: Case and technique

“…The pedicled pectoralis major osteomyocutaneous flap is infrequently described in the literature, 1–4 and the initial case series with technical details and intraoperative photographs was published in 1980 5,6 . At least 181 cases have been reported to‐date 1–11 .…”

“…5,6 At least 181 cases have been reported to-date. [1][2][3][4][5][6][7][8][9][10][11] A large series of 114 patients was reported by Savant et al out of India in 1994, in which this technique was their preferred method for head and neck bony reconstruction. 10 Regarding complications, of the 181 cases, there were 31 reported cases of bony resorption or flap failure (20%).…”

“…The pedicled pectoralis major osteomyocutaneous flap is infrequently described in the literature, 1–4 and the initial case series with technical details and intraoperative photographs was published in 1980 5,6 . At least 181 cases have been reported to‐date 1–11 . A large series of 114 patients was reported by Savant et al out of India in 1994, in which this technique was their preferred method for head and neck bony reconstruction 10 .…”