[The myofascial pectoralis major flap for tissue replacement in the oral cavity]

Since the original description by Ariyan, the myocutaneous pectoralis-major-(p.m.-)flap has been widely used for soft tissue replacement in the head and neck. In our department this flap has been established as a reliable and versatile method for soft tissue replacement in a variety of tumour defects. In the oral cavity a great number of different surgical procedures have been described for reconstruction of soft tissue defects. However, most surgeons still seem to be using either myocutaneous p.m.-flaps or the so-called "free flaps" (radial forearm flap, free jejunal flap). Authors advocating the "free flaps" usually emphasize the disadvantages of the myocutaneous p.m.-flap (bulk of tissue in the neck and at the recipient site, possible hair-bearing skin, alteration of breast position). During the last two years we have been adding the myofascial p.m.-flap to our surgical repertoire for soft tissue replacement in the oral cavity, because of its lack of disadvantages mentioned for the myocutaneous version. Our experience with the myofascial p.m.-flap for intraoral reconstruction in 14 patients with squamous cell carcinomas of the anterior floor of mouth (8) and tongue (4) are described and discussed in comparison with the "free flaps" used in this region.