Mohammad Tahir, Tahmeedullah, Amir Taimur Khan.
Clinical evaluation of pectoralis major myocutaneous flap in head and neck reconstruction.
J Postgrad Med Inst Jan ;19(1):71-5.

Objective: Clinical evaluation of Pectoralis Major Myocutaneous flap in head and neck reconstruction. Material and Methods: In this study we analyzed 20 consecutive Pectoralis Major Myocutaneous Flaps used for head and neck reconstruction since Sept. 1999 to Dec. 2000. Head and neck cancers form approximately 90% of patients undergoing major surgery and reconstruction with Pectoralis Major Myocutaneous Flaps. While head and neck trauma accounts for 10% of the cases. Results: Among the head and neck neoplasia patients the majority of the cases were advanced lesions in stage III, IV. The majority of them were in the 5th and 6th decades of their lives. The most common type of primary tumour was squamous cell carcinoma (n=18)(90%), the most commonly tumour involved area in our series was the right mandibular region (66.6%), followed by left mandibular area (22.2%). Right buccal mucosal involvement was observed in 11.1 % of patients. About eighty-three (83.3%) of patients underwent primary surgery, while the rest (16.6%) were operated on for residual or recurrent disease. A total of (n=12) 60% of patients experienced no complications, while wound dehiscence was the most common complication. Speech was found to be normal or easily intelligible in 50% patients. Oral continence was normal in 5% of patients, with occasional drooling in 75% and continuous drooling in 20%. 15% patient thought to have a good aesthetic outcome postoperatively. The majorities were thought to have an acceptable result (60%); a poor result (15%) or failure (10%) was seen in the remainder. Conclusion: Pectoralis Major Myocutaneous Flap can be used for reconstructions of large head and neck defects with acceptable outcome results.

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