Immediate reconstruction following resection of oral cancer with pectoralis major myocutaneous flap.

During the past five years (August 1981 to March 1986), we applied 44 pectoralis major myocutaneous flaps (PM-MC flaps) for the purpose of intraoral and extraoral reconstruction following surgery in 43 cases of oral cancer. Out of a total 44 flaps, 30 flaps resulted in complete survival and 13 flaps resulted in partial necrosis, while complete necrosis occurred in only one flap. In addition, we used the iliac bone graft with the PM-MC flaps on five patients in order to reconstruct the mandible, but two cases failed. We also used replantation of the lower margin of the mandible on five patients, and all were satisfactory. In 26 living patients, all but one had no dysphasia. About more than a half of them had moderate or severe dysfunction of chewing. We were able to make prosthesis for five out of 26 living patients as recorded till today. We have to think about how to fashion functionable dentures on severe cases postoperatively. The results of our experiences show that the PM-MC flaps provide a simple, reliable and versatile method of primary reconstruction on patients with oral cancer.