THE PECTORALIS MAJOR MUSCLE IN HEAD AND NECK RECONSTRUCTION

Abstract
From June 1980 to June 1985 51 pectoralis major muscle flaps have been used for one-stage reconstruction of extensive defects in the head and neck following cancer surgery. The pectoralis major muscle was used as a myocutaneous flap on 28 occasions, as a muscle covered with split thickness skin on 17 occasions, and as a muscle-only flap six times. The muscle, in its various forms, was used for reconstruction of the pharyngo-oesophageal segment, the tongue, floor of the mouth and oropharynx, to replace the skin of the face and neck, and to provide a well vascularized recipient bed for a split-rib graft, used to replace a defect of the anterior arch of the mandible. Many of the problems associated with the use of a pectoralis major myocutaneous flap can be avoided by the judicious use of a muscle flap on its own or covered by a split thickness skin graft.

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