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Combined Use of Pectoralis Major Myocutaneous Flap and Deltopectoral Flap for the Reconstruction of Advanced Oral Cancers: Our Experience in 29 Cases

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Abstract

Purpose

To assess the utility of the combined use of pectoralis major myocutaneous (PMMC) flap and deltopectoral flap (DP) in advanced oral cavity cancers in the Indian population.

Materials and Methods

It is a retrospective study, considering 29 patients with stage IV carcinoma of the oral cavity, from July 2015 to February 2019. Both pectoralis major Myocutaneous flaps and deltopectoral flaps were used for stage IV oral cancers involving the full-thickness cheek and the mandibular cortex. The reliability of the flaps and clinical outcomes were evaluated in the postoperative period.

Results

Of the 29 patients, partial necrosis of the skin island was detected in 6 patients, 2 patients presented with wound dehiscence, and one patient had an orocutaneous fistula. Recurrence was detected in 3(10.34%) patients, in one patient, it was at the primary site and in 2 patients, it was in the neck. When different parameters were compared between the patients with complications and without complications, the comorbidities like smoking and alcohol intake adversely affected the flap survival in the postoperative period.

Conclusions

The combined use of PMMC and DP flap can be a reliable option for advanced oral malignancies, especially in patients with poor performance 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, these pedicle flaps can be successfully used alternative to the free flaps in advanced oral cancers, especially patients with a low socioeconomic corridor like India.

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Data Availability

The data can be obtained on request.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India

    Pradeep Pradhan, Chappity Preetam, Sourav Sarkar, Dillip Kumar Samal & Pradipta Kumar Parida

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  1. Pradeep Pradhan
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  2. Chappity Preetam
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  3. Sourav Sarkar
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  4. Dillip Kumar Samal
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  5. Pradipta Kumar Parida
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Correspondence to Pradeep Pradhan.

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Consent to Participate

Written and informed consent was taken from each patient for the surgical intervention.

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An informed consent was taken from each patient for publication.

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Appendix 1

Appendix 1

Karnofsky performance status score.

The Karnofsky score measures patient performance of activities of daily living.

Karnofsky scores at the time of tumour diagnosis have the best survival and quality of life over the course of their illness.

100- Normal, no evidence of disease.

90- Able to perform normal activity with only minor symptoms.

80- Normal activity with effort, some symptoms.

70- Able to care for self but unable to do normal activities.

60- Requires occasional assistance, cares for most needs.

50- Requires considerable assistance.

40- Disabled, requires special assistance.

30- Severely disabled.

20- Very sick, requires active supportive treatment.

10- Moribund.

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Pradhan, P., Preetam, C., Sarkar, S. et al. Combined Use of Pectoralis Major Myocutaneous Flap and Deltopectoral Flap for the Reconstruction of Advanced Oral Cancers: Our Experience in 29 Cases. J. Maxillofac. Oral Surg. 21, 312–319 (2022). https://doi.org/10.1007/s12663-020-01464-2

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