Published: 2017-01-16

Pectoralis major myocutaneous flap in head and neck reconstruction: an interesting experience from central India regional cancer center

Ashutosh Gupta, Gunjan Agrawal, Santanu Tiwari, Kshitij Verma, Rajesh Agrawal, Vivek Choudhary


Background: Head and neck cancer are sixth most common cancers worldwide with cancer of oral cavity most common. The primary treatment modality for oral cavity cancer has been surgery and defects resulting from the ablation of the tumors require reconstruction. the PMMC flap offer an easy, less time consuming with minimal postoperative complication as a reconstructive option in the hands of reconstructive surgeon. The objective of our study was to give a precise description of our experience with the PMMC flap as a reconstructive option in post-ablative head and cancer surgery.

Methods: The current prospective study was conducted in the Department of Surgical Oncology, Regional cancer center, Pt. JNMC, Raipur (C.G.), India from the January 2014 to June 2015. Detailed clinical history and examination of the patients were recorded. All Investigations relevant to the study were done before the surgical procedure. Procedure was performed as per standard protocol and reconstruction was made with PMMC flap. Data was compiled in MS Excel and checked for its completeness and correctness. Then it was analyzed.

Results: In the present study male to female ratio was 2:1. Most of the patients belongs to the age group of 41-60 (55.55%) followed by 21-40 (30.15%). In the present study majority of patient of oral malignancy presented with lower alveolus malignancy (36.5%) followed by buccal mucosa malignancy (19.06%).

Conclusions: Pectoralis major myocutaneous flap was found to be a versatile flap for reconstruction of large defects in Head and Neck region with minimal complication rate.



Head and neck reconstruction, Head and neck cancer, Oral cancer, PMMC flap, Orocutaneous fistula

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Rahamthullah US, Hussain SJ, Nasyam FA, Allareddy S. Pectoralis Major Myocutaneous Flap in Oral and Maxillofacial Reconstruction: A case Report. J Res Adv Dent. 2015; :1s2:64-7.

Amin MM, Naseer U, Akhtar A, Awan AA. Pectoralis Major Myocutaneous Flap for Reconstruction of Major Neck Defects. Journal of Surgery Pakistan. 2014;19(2).

Pangam N, Thorawade V, Shah R, Jagade M, Nichalani S. Study of Surgical Management and Locoregional Flap Reconstruction in Oral Malighancies. Journal of Dental and Medical Science. 2014;13(5):93-6.

Leite AKN, Matos DLL, Belli M, Kulsar MAV, Cernea CR, Brandao LG, et al. Pectoralis Major Myocutaneous Flap for Head and Neck Reconstruction. Acta Otorhinolaryngologica Italica. 2014;34:389-93.

Reddy VC, Vijaya M, Sabitha, KS, Chris DA, Mahesh K, Jagdish S. Pectoralis Major Myocutaneous (PMMC) Flap Donor Site Recurrence in a Case of Buccal Mucosal Cancer: A Case Report. International Journal of Health Science and Research. 2013;3(1):55-7.

Lekawale H, Patil B. Pectoralis Major Myocutaneous Flap for Oral Cavity Cancer Reconstruction - Our Experience with 30 Cases. 2012;2(3):159-61.

Saitu A, Minakawa H, Saito N, Nagahashi T. Indications and Outcomes for Pedicled Pectoralis Major Myocutaneous Flap at a primary Microvascular head and Neck Reconstructive Center. Modern Plastic Surgery. 2012;2:103-7.

Rehman QB, Karmakar R, Kumar S. Thoraacromial Vessel Based Pectoralis Major Myocutaneous Flap in Oral and Maxillofacial Soft Tissue Defect Reconstruction. AKMMC J. 2012;3(2):23-9.

Sathyanarayan GR, Suresh K P, Prabhu V. Pectoralis Major Myocutaneous(PMMC) Flap for Reconstruction of oro Facial Defect. JIADS. 2011;2(2):76-8.

Rudes M, Bilic M, Jurlina M, Prgomet D. Pectoralis Major Myocutaneous Flap in the Reconstructive Surgery of the Head and Neck-Our Experience. Coll. Antropol. 2012;36(2):137-42.

Tahir M, Tahmeedullah, Khan AT. Clinical Evaluation of Pectoralis Major Myocutaneous Flap in Head and Neck Reconstruction. JPMI. 2005;19(1):71-5.

Vartanian JG, Carvalho AL, Solange MT, Carvalho, Mizobe L, Magrin J, et al. Pectoralis Major and Other Myofacial/Myoutaneous Flap in Head and Neck Cancer Reconstruction: Experience with 437 Cases at a Single Institute. Head and Neck. 2004;1018-23.

Deo SVS, Purkayastha J, Das D, Kar M, Srinivas G, Asthana S, et al. Reconstruction of Complex Oral Defects using Bi-Paddle Pectoralis Major Flap –Technical Modifications and Outcome in 54 Cancer Patients. Indian Journal of Otolaryngology and Head and Neck Surgery. 2003;55(1):5-9.

Belt PJ, Emmett J. Local Transposition Flap Repair of the Pectoralis Major Myocutaneous Flap Donor Site. Plastic and Reconstructive Surgery. 2004;114(3):732-7.

Gurbachan I, Gomez AC, Noor N. Pectoralis Major Myocutaneous Flap in Head and Neck Surgery. Med. J. Malaysia. 1985;40(2):107-14.