Pectoralis major myofascial flap in head and neck reconstruction: indications and outcomes

To review the pectoralis major myofascial (PMMF) flap in head and neck reconstruction.

Twenty-seven consecutive patients who underwent a PMMF reconstruction between March 1, 2001, and October 1, 2004, were retrospectively reviewed, which, to date, has generated the largest documented series among the world literature. Data acquisition centred on indications for use, tumour staging, defect location, type of wound, and complications (major and minor).

Thirteen patients had resections of the primary tumour, whereas 13 others had recurrent disease. Stages varied from T0 to rN3. A variety of defects were filled, but the majority of defects were in the oral cavity (13; 48%). Indications ranged from pure soft tissue filling to salvage of previously failed reconstructions. The outcomes were evaluated as 24 (89%) successes and 6 (22%) major and 6 (22%) minor complications overall, but when only considering cases done for reconstructive salvage, the failure rate is high (3; 50%).

The PMMF flap remains a successful reconstructive option; however, when used in the context of previously failed reconstructive efforts, the morbidity of the PMMF flap is much higher.