Pradhan Pradeep, Samal Swagatika, Preetam C, Samal Dillip Kumar, Parida Pradipta Kumar
Department of Otorhinolaryngology, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019 India.
Indian J Otolaryngol Head Neck Surg. 2018 Sep;70(3):415-420. doi: 10.1007/s12070-018-1429-x. Epub 2018 Jun 20.
To evaluate the utility of the pectoralis major myocutaneous (PMMC) flap for the reconstruction of the mandible in advanced oral cavity malignancies in the Indian population. It was a retrospective study contained 30 patients with advanced oral cancer from July 2012 to August 2016. The PMMC reconstruction was done in all the patients to repair the bony defects in segmental/hemi mandibulectomy. The patients were followed up for a mean period of 6 months in the postoperative period and the utility of the PMMC flaps were evaluated. The mean age of the patients was 45 years (range 30-63 years). The average Karnofsky performance status score was 70 and majority of the patients had history of chronic medical illness. Of the 30 PMMC flaps, partial necrosis of the skin was noticed 2 (06.66%) patients. Orocutaneous fistula was detected in 2 (06.66%) patient and 3 (10%) patients presented with wound dehiscent in the immediate postoperative period. 3 (10%) patients had recurrence of the disease. PMMC flap can be a reliable option for advanced oral malignancies, especially in patients with poor status with the coexisting chronic illness. Due to the presence of a definite vascular pedicle, ease of harvesting the flap, quick surgical procedure, and the minimal postoperative morbidities, it can be considered as a valid alternative to the free flap to repair the bony defect, especially in patients with low socioeconomic corridor like India.
评估胸大肌肌皮瓣(PMMC)在印度人群晚期口腔恶性肿瘤下颌骨重建中的应用价值。这是一项回顾性研究,纳入了2012年7月至2016年8月期间的30例晚期口腔癌患者。所有患者均采用PMMC重建术修复节段性/半侧下颌骨切除术后的骨缺损。术后对患者进行了平均6个月的随访,并评估了PMMC皮瓣的应用效果。患者的平均年龄为45岁(范围30 - 63岁)。平均卡诺夫斯基功能状态评分为70分,大多数患者有慢性病史。在30例PMMC皮瓣中,2例(06.66%)患者出现皮肤部分坏死。2例(06.66%)患者检测到口皮瘘,3例(10%)患者在术后即刻出现伤口裂开。3例(10%)患者疾病复发。PMMC皮瓣对于晚期口腔恶性肿瘤是一种可靠的选择,尤其是对于伴有慢性疾病且身体状况较差的患者。由于存在明确的血管蒂,皮瓣切取容易,手术操作迅速,术后并发症少,它可被视为修复骨缺损的游离皮瓣的有效替代方案,特别是在像印度这样社会经济水平较低的地区。