Analysis of 130 Cases of Pectoralis Major Flap for the Head and Neck Reconstruction

Received June 17, 2015 Revised September 8, 2015 Accepted September 9, 2015 Address for correspondence Young-Ik Son, MD Department of OtorhinolaryngologyHead and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul 06351, Korea Tel +82-2-3410-3577 Fax +82-2-3410-6987 E-mail yison@skku.edu Background and ObjectivesZZPectoralis major flap is the most versatile and reliable flap in the head and neck reconstruction. Owing to the recent development of microsurgical techniques, free flap reconstruction is gaining its popularity as a primary option for the reconstruction of head and neck defects. However, pectoralis major flap is a useful workhorse for the wide variety of situations including heavily irradiated neck, failure of prior reconstruction, and poor recipient vascular status. This study aimed to review our experience of pectoralis major flap surgery and to evaluate its clinical usefulness. Subjects and MethodZZWe reviewed medical records of 113 patients (130 cases) who underwent pectoralis major flap surgery from 1995 to 2014. Indications and complications of pectoralis major flap surgery were evaluated. Association between complication rates and clinical factors were analyzed. ResultsZZReconstruction of primary surgical defect was the most common indication (n=81/130, 62.3%). Complications developed in 17 cases (13.1%). Flap failure was observed in 2 cases (1.5%). The length of flap pedicle was closely related with complication rate (p=0.01). However, other factors including flap size, types of flap, radiation history did not influence complication rate. ConclusionZZPectoralis major flap is still a very useful option with a relatively low risk of complication for the head and neck reconstruction even in the era of frequent free flap surgery and heavy irradiation. Korean J Otorhinolaryngol-Head Neck Surg 2016;59(2):133-9