[Application of modified pectoralis major myocutaneous flap in advanced head and neck cancer].

OBJECTIVE

To analyze a producing method for modified pectoralis major myocutaneous (PMM) flap, with maintaining the function of pectoralis major muscle.

METHODS

The skin island was designed according to the anatomical features of pectoralis major myocutaneous flap. The pedicle of PMM flap did not contain any muscle, making PMM flap into an accurate island flap. The clavicle of pectoralis major muscle as well as most of lateral part fiber was well maintained.

RESULTS

From 2002 to 2005, 29 PMM flaps were performed by this modified method, 20 flaps used to reconstruct defect of oral, 4 flaps to reconstruct defect of neck, 3 flaps to reconstruct defect of parotid gland and 2 flaps to reconstruct laryngopharynx. All flaps were survival postoperation. The speaking and swallowing functions were satisfactory after 6 months approximately 2 years' follow-ups.

CONCLUSIONS

The application of modified pectoralis major myocutaneous flap overcomes the disadvantage of outdated method, improving the feasibility and availability of blood supply of muscle flap. Besides, it almost maintains the function of pectoralis major muscle and the appearance features of chest. Thus, this modified technique turns this flap more reliable and versatile in head and neck.