Department of Surgery, Division of Otolaryngology, Dalhousie University, Halifax, Nova Scotia.
J Otolaryngol Head Neck Surg. 2009 Dec;38(6):632-41.
To review the pectoralis major myofascial (PMMF) flap in head and neck reconstruction.
Twenty-seven consecutive patients who underwent a PMMF reconstruction between March 1, 2001, and October 1, 2004, were retrospectively reviewed, which, to date, has generated the largest documented series among the world literature. Data acquisition centred on indications for use, tumour staging, defect location, type of wound, and complications (major and minor).
Thirteen patients had resections of the primary tumour, whereas 13 others had recurrent disease. Stages varied from T0 to rN3. A variety of defects were filled, but the majority of defects were in the oral cavity (13; 48%). Indications ranged from pure soft tissue filling to salvage of previously failed reconstructions. The outcomes were evaluated as 24 (89%) successes and 6 (22%) major and 6 (22%) minor complications overall, but when only considering cases done for reconstructive salvage, the failure rate is high (3; 50%).
The PMMF flap remains a successful reconstructive option; however, when used in the context of previously failed reconstructive efforts, the morbidity of the PMMF flap is much higher.
回顾胸大肌肌筋膜皮瓣在头颈部重建中的应用。
回顾性分析 2001 年 3 月 1 日至 2004 年 10 月 1 日期间连续 27 例接受胸大肌肌筋膜皮瓣重建的患者，这是迄今为止世界文献中最大的记录系列。数据采集集中在适应证、肿瘤分期、缺损部位、创面类型和并发症（主要和次要）。
13 例患者行原发性肿瘤切除术，13 例患者行复发性疾病切除术。分期从 T0 到 rN3 不等。多种缺损被填补，但大多数缺损位于口腔（13 例；48%）。适应证范围从单纯软组织填充到先前失败重建的挽救。总的来说，24 例（89%）为成功，6 例（22%）为主要并发症，6 例（22%）为次要并发症，但仅考虑用于重建挽救的病例时，失败率较高（3 例；50%）。
胸大肌肌筋膜皮瓣仍然是一种成功的重建选择；然而，当用于先前失败的重建努力时，胸大肌肌筋膜皮瓣的发病率要高得多。
