Mamoon Rashid, Muhammad Shahzad Hanif, Danyal Rashid, Bashir Ahmad, Irfan Illahi, Rizwan Aslam.
Reconstruction of Hypopharyngeal defects with Pectoralis Major Myocutaneous Flap.
J Coll Physicians Surg Pak Jan ;12(7):425-8.

Objective: To emphasize the safety and efficacy of the pectoralis major myocutaneous flap (PMMF) in reconstruction of hypopharyngeal defects. Design: Descriptive study. Place and Duration of study : Study was conducted at the Departments of Plastic and Reconstructive Surgery and Otolaryngology, Combined Military Hospital, Rawalpindi over a 3 years period. Patients and Methods: Fourteen consecutive patients who underwent primary reconstruction with a PMMF, after resection of a hypopharyngeal carcinoma, were included in this study. All the patients had defects above the clavicle and were resected by the same head and neck surgical team. Similarly, a single plastic surgery team performed the reconstructions. The variables including operation time, flap survival, functional outcome and postoperative complications were recorded. Results: Of the 14 patients, 5 were men and 9 women. The mean age was 56 years. Five patients had received pre-operative radiotherapy. Average operating time for the reconstruction was 2.8 hours. Hospital stay ranged from 10 to 14 days. There was no operative mortality or flap loss in our series. Stenosis was seen in 29% and fistula in 21% of patients. All the patients were able to swallow within 2 to 10 weeks after surgery. Eight patients maintained or gained weight while 4 patients could develop appreciable esophageal speech. Conclusion: Reconstruction of hypopharyngeal defects with PMMF is recommended for its ease of performance, absence of intraperitoneal approach, greater conservation of patient and public resources and predictably good results.

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