The pectoralis major costomyocutaneous flap for mandibular reconstruction.

In this paper we present a series of 14 pectoralis major costomyocutaneous flaps employed on patients who required mandibulectomy for oral tumors. Experience with this previously described technique is analyzed and its complications are presented. Although the pectoralis major muscle does not originate from the ribs, there appears to be enough blood supply by means of the delicate areolar connections and the periosteum to sustain the costal segment. In an attempt to improve the blood supply by means of the perichondrium, we have included a portion of the costal cartilage. In our series there were three failures resulting probably from technical errors. Apart from these, the results were satisfactory. However, the use of this procedure is relatively recent, and its long-term results are unknown at the moment.