Article

Salvage Reconstruction of Extensive Recurrent Oral Cancer Defects With the Pectoralis Major Myocutaneous Flap

Department of Oral and Maxillofacial Surgery, and Research Fellow, Key Laboratory of Oral Biomedical Engineering (Wuhan University), Ministry of Education, School and Hospital of Stomatology, Wuhan University, Wuhan, PR China.
Journal of Oral and Maxillofacial Surgery (Impact Factor: 1.28). 11/2007; 65(10):1935-9. DOI: 10.1016/j.joms.2006.10.067
Source: PubMed

ABSTRACT This study aimed to evaluate the usefulness of the pectoralis major myocutaneous flap for reconstruction of oral and facial defects after excision of recurrent oral cancer and the results of salvage surgery.
Twenty-four patients with recurrent squamous cell carcinoma of the oral cavity underwent salvage surgical treatment. Pectoralis major flaps were used for reconstruction of the extensive defects caused by excision of the tumors. The complications of the flap and the prognosis of the patients were analyzed with a follow-up from 5 to 65 months (mean = 18.5 months).
Fourteen flaps were used for mucosal lining of the mouth, and 10 flaps were used for reconstruction of the cutaneous defects. The overall success rate of the flap was 70.8%. Flap-related complications developed in 13 patients (54.2%). Major complications occurred in 7 patients (29.2%), and minor complications occurred in 6 (25.0%). Three patients (12.5%) had complications unrelated to the flap. The reconstruction of the base of the tongue, the floor of the mouth, and the oropharynx emerged as a significant risk factor for flap necrosis on binary logistic regression analysis (P < .05). The overall 1-, 3-, and 5-year overall survival rate was 72.8%, 30.9%, and 20.6%, respectively.
The pectoralis major myocutaneous flap is a reliable choice for reconstruction of extensive soft tissue defects caused by excision of recurrent oral cancer. The major complications correlate with the site of reconstruction. Many patients benefit from salvage surgery, and some of them can survive 2 to 4 years postoperatively.

0 Followers
 · 
166 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: This chapter discusses the unique challenges in the diagnosis, workup, treatment and follow-up of patients who may have, or have failed chemoradiation protocols. The role of various imaging modalities, particularly PET scanning, is reviewed. Surgical salvage in this population is emphasized, addressing the extent of resection both at the primary site and the neck, and the surgical complications encountered in this population. Options for surgical reconstruction are discussed, including free tissue transfer. While surgical salvage is the main focus of this chapter, other salvage modalities available to patients who have been previously chemoirradiated are examined. These include ­re-irradiation with or without chemotherapy, brachytherapy and photodynamic therapy. Finally, the treatment outcomes with respect to morbidity and mortality in this population are reviewed.
  • [Show abstract] [Hide abstract]
    ABSTRACT: A methodology for constructing a rule-base from learned data and a modified tuning algorithm with fuzzy least squares method are described
    Instrumentation and Measurement Technology Conference, 1996. IMTC-96. Conference Proceedings. 'Quality Measurements: The Indispensable Bridge between Theory and Reality'., IEEE; 02/1996
  • [Show abstract] [Hide abstract]
    ABSTRACT: A thin layer of low temperature grown GaAs (LT-GaAs) incorporated in the intrinsic layer of a pin diode was used, to investigate the deep electronic defect centers in LT-GaAs, DC and AC n-channel conductance measurements and electro-absorption experiments as a function of reverse bias provide important information about the density, the energy distribution and the charging and discharging kinetics of the deep centers in the energy gap
    Semiconducting and Insulating Materials Conference, 2000. SIMC-XI. International; 02/2000
Show more