Osteomyocutaneous flap reconstruction for major mandibular defects

Area of Science:

• Oral and Maxillofacial Surgery
• Surgical Oncology
• Reconstructive Surgery

Background:

• Mandibular defects from buccal mucosa carcinoma resections necessitate prompt restoration of form, function, and aesthetics.
• The pectoralis major osteomyocutaneous flap (PM-OMC) is a viable option for immediate reconstruction.
• This flap offers a comprehensive solution, addressing bone, soft tissue, and skin deficits.

Purpose of the Study:

• To evaluate the efficacy of the pectoralis major osteomyocutaneous flap (PM-OMC) in reconstructing mandibular defects.
• To assess functional outcomes, including mastication, swallowing, and speech, following PM-OMC flap reconstruction.
• To demonstrate the technical simplicity and applicability of the PM-OMC flap in a diverse surgical training setting.

Main Methods:

• A retrospective review of 116 pectoralis major osteomyocutaneous (PM-OMC) flap reconstructions for mandibular defects.
• Surgical procedures performed by a range of surgical staff, from consultants to residents in training.
• Postoperative assessment of functional outcomes, including mastication, swallowing, and speech intelligibility.

Main Results:

• Successful reconstruction using the pectoralis major osteomyocutaneous flap (PM-OMC) in 116 patients.
• Over 70% of patients achieved good postoperative mastication.
• Satisfactory swallowing and intelligible speech were reported in 85% of patients.

Conclusions:

• The pectoralis major osteomyocutaneous flap (PM-OMC) is a reliable and effective method for mandibular reconstruction after oncologic resection.
• The flap provides excellent functional and cosmetic restoration with minimal morbidity.
• Its technical simplicity makes it suitable for various levels of surgical expertise.