[Pedicled and microvascular reanastomosed transplants for reconstruction in the head-neck area]

The introduction of the pectoralis major myocutaneous flap has opened up new dimensions for reconstruction following radical resection of advanced oral and pharyngeal malignancies. We report our 12-year experience with 89 patients in whom reconstruction with a pectoralis major flap was performed. The advantage of this technique is that it involves a single-stage reconstruction; moreover, the carotid artery is protected after neck dissection and soft tissue defects can be remodelled with the added bulk of the myocutaneous flap. On the other hand, the applicability of the technique is limited by the rigidity of the flap and the length of the vascular pedicle. These problems were solved by free tissue transfer. The excellent functional and aesthetic results of reanastomosed transplants have led to the myocutaneous pectoralis major flap being replaced at the Department of Otolaryngology in Tübingen.