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Published in: Journal of Maxillofacial and Oral Surgery 1/2024

04-08-2023 | Oral Cancer | ORIGINAL ARTICLE

Submammary Approach for Harvesting Pectoralis Major Myocutaneous Flap in Females with Oral Cavity Cancers: Report of Technique and Our Experience

Authors: Durgesh Kumar, Indu Shukla, Ankur Verma, Ashok Kumar Singh

Published in: Journal of Maxillofacial and Oral Surgery | Issue 1/2024

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Abstract

Background

Oral squamous cell carcinoma is one of the most common types of cancers affecting both male and female population worldwide. Currently gold standard for reconstruction of oral cavity defects is free flap reconstruction. However, in developing countries due to large case load, infrastructural and resource constraints, Pectoralis major myocutaneous flap is still widely being used. Harvesting PMMC flap in females is challenging due to thick fat and breast tissue affecting its reliability and also increased donor site morbidity. This article aims at highlighting our experience with harvesting PMMC flap in female patients by submammary approach and its outcomes.

Methods

A total of 23 female patients who underwent wide local excision of oral cavity cancers and reconstruction with PMMC flap were included. Data was analysed as mean, median, mode, percentages and statistical averages.

Results

Majority of patients belonged to 40–60 years of age group (60.86%). Buccal mucosa was the most common site of primary lesion in 16 patients (69.56%). Out of the 23 patients who underwent PMMC flap reconstruction, recipient site complications were seen in 4 patients including total flap loss in 2 patients (8.69%), minor complications, e.g. infection in 2 patients (8.69%). Donor site morbidity in the form of axillary seroma was seen in only 1 patient (4.34%).

Conclusion

In our experience, PMMC flap is still a viable option for reconstruction especially in resource constraint settings. Submammary approach to PMMC flap harvest is a safe technique as it is associated with minimum recipient site complications whilst preserving donor site anatomy and thereby reducing donor site morbidities to minimum.
Literature
3.
go back to reference Chala A (2020) Modalities and state of art in oral cancer reconstruction. In: Sridharan G, Sukumaran A, Ostwani AEOA (eds) Oral diseases [Internet]. IntechOpen, London Chala A (2020) Modalities and state of art in oral cancer reconstruction. In: Sridharan G, Sukumaran A, Ostwani AEOA (eds) Oral diseases [Internet]. IntechOpen, London
5.
go back to reference Jena A, Patnayak R, Sharan R, Reddy SK, Manilal B, Rao LM (2014) Outcomes of flap in female patients for oral cavity defect reconstruction. J Oral Maxillofac Surg 72:222–231CrossRefPubMed Jena A, Patnayak R, Sharan R, Reddy SK, Manilal B, Rao LM (2014) Outcomes of flap in female patients for oral cavity defect reconstruction. J Oral Maxillofac Surg 72:222–231CrossRefPubMed
8.
go back to reference Chaturvedi P, Pathak KA, Pai PS, Chaukar DA, Deshpande MS, D’Cruz AK (2004) A novel technique of raising a pectoralis major myocutaneous flap through the skin paddle incision alone. J Surg Oncol 86:105–106CrossRefPubMed Chaturvedi P, Pathak KA, Pai PS, Chaukar DA, Deshpande MS, D’Cruz AK (2004) A novel technique of raising a pectoralis major myocutaneous flap through the skin paddle incision alone. J Surg Oncol 86:105–106CrossRefPubMed
9.
go back to reference Mehta S, Sarkar S, Kavarana N et al (1996) Complications of the pectoralis major myocutaneous flap in the oral cavity: a prospective evaluation of 220 cases. Plast Reconstr Surg 98:31–37CrossRefPubMed Mehta S, Sarkar S, Kavarana N et al (1996) Complications of the pectoralis major myocutaneous flap in the oral cavity: a prospective evaluation of 220 cases. Plast Reconstr Surg 98:31–37CrossRefPubMed
10.
go back to reference Chakrabarti S, Chakrabarti PR, Desai SM, Agrawal D, Mehta DY, Pancholi M (2015) Reconstruction in oral malignancy: factors affecting morbidity of various procedures. Ann Maxillofac Surg 5(2):191–197CrossRefPubMedPubMedCentral Chakrabarti S, Chakrabarti PR, Desai SM, Agrawal D, Mehta DY, Pancholi M (2015) Reconstruction in oral malignancy: factors affecting morbidity of various procedures. Ann Maxillofac Surg 5(2):191–197CrossRefPubMedPubMedCentral
13.
go back to reference Mehta S, Agrawal J, Pradhan T, Goel A, Kumar K, Dewan AK et al (2016) Preservation of aesthetics of breast in pectoralis major myocutaneous flap donor site in females. J Maxillofac Oral Surg 15:268–271CrossRefPubMed Mehta S, Agrawal J, Pradhan T, Goel A, Kumar K, Dewan AK et al (2016) Preservation of aesthetics of breast in pectoralis major myocutaneous flap donor site in females. J Maxillofac Oral Surg 15:268–271CrossRefPubMed
14.
go back to reference Bhattacharya S, Panuganti A, Thankappan K, Balasubramanian D, Iyer S (2021) Pectoralis major myocutaneous flap in females: report of the technique and literature review. J Head Neck Physicians Surg 9:159–162 Bhattacharya S, Panuganti A, Thankappan K, Balasubramanian D, Iyer S (2021) Pectoralis major myocutaneous flap in females: report of the technique and literature review. J Head Neck Physicians Surg 9:159–162
15.
go back to reference Jayaprakash D, Nandy K, Tripathi U, Mithi MT, Vyas R, Sadangi S (2021) Bilobed PMMC in females: our challenging yet meritorious experience. Indian J Surg Oncol 12(1):39–47CrossRefPubMed Jayaprakash D, Nandy K, Tripathi U, Mithi MT, Vyas R, Sadangi S (2021) Bilobed PMMC in females: our challenging yet meritorious experience. Indian J Surg Oncol 12(1):39–47CrossRefPubMed
Metadata
Title
Submammary Approach for Harvesting Pectoralis Major Myocutaneous Flap in Females with Oral Cavity Cancers: Report of Technique and Our Experience
Authors
Durgesh Kumar
Indu Shukla
Ankur Verma
Ashok Kumar Singh
Publication date
04-08-2023
Publisher
Springer India
Published in
Journal of Maxillofacial and Oral Surgery / Issue 1/2024
Print ISSN: 0972-8279
Electronic ISSN: 0974-942X
DOI
https://doi.org/10.1007/s12663-023-01984-7

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