The pectoralis major muscle flap without skin in intra-oral reconstruction

Phillips, John G.; Postlethwaite, K.R.; Peckitt, Ninian S.

doi:10.1016/0266-4356(88)90069-1

Cited by 40 publications

(24 citation statements)

References 8 publications

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“…1,2,5 The PMMF flap is similar except that the overlying fascia, subcutaneous fat, and skin are left in situ. 7,8,[11][12][13][14] A lateral to medial oblique incision is made over the pectoralis major muscle on the thorax. In women, the incision is inframammary and therefore preserves postoperative breast symmetry to the maximal extent possible ( Figure 1).…”

Section: Methodsmentioning

confidence: 99%

Pectoralis major myofascial flap: A valuable tool in contemporary head and neck reconstruction

et al. 1997

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Section: Methodsmentioning

confidence: 99%

Pectoralis major myofascial flap: A valuable tool in contemporary head and neck reconstruction

et al. 1997

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“…15 The flap tends to be bulky due to the adipose tissue between the muscle and skin, and the gravitational pull of a heavy, thick skin paddle may contribute to wound dehiscence. Excessive bulk in the aerodigestive tract may interfere with recovery of swallowing function.…”

mentioning

confidence: 99%

The Pectoralis Major Myofascial Flap for Intraoral and Pharyngeal Reconstruction

Shindo

Costantino

Friedman

et al. 1992

Archives of Otolaryngology - Head and Neck Surgery

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“…This finding can create difficulties with food and mucus clearance that can subsequently affect eating, speech, and nasal airflow. Prior studies 8,15,16 …”

Section: Research Original Investigation Thigh Adipofascial Flap In Mmentioning

confidence: 99%

Anterolateral Thigh Adipofascial Flap in Mucosal Reconstruction

Revenaugh

Haffey

Seth

et al. 2014

JAMA Facial Plast Surg

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arge mucosal defects can be challenging to the reconstructive surgeon. Throughout the oral and nasal cavities, the mucosa is a thin, compliant, and functional membrane providing properties necessary for mastication, food bolus control, speech, and nasal airway patency. The unique properties and limited supply of mucosa are fundamental difficulties in reconstruction of large defects. With larger mucosal defects, complicated closures, or irradiated fields, microvascular-free tissue transfer often is indicated to ensure vascularized coverage.The anterolateral thigh (ALT) flap has recently become a "workhorse" of head and neck reconstruction. Since its description as a musculocutaneous free flap by Song et al in 1984, 1 the ALT has been adopted for a number of indications. The flap is reliably vascularized by several perforators off of the descending or transverse branch of the lateral circumflex femoral artery. Although predominantly musculocutaneous, all of these perforators traverse the fascia overlying the vastus lateralis (fascia lata) as well as the subcutaneous fat before terminating in the subdermal plexus. 2 Consequently, the ALT flap can be harvested without skin and without inclusion of muscle surrounding the perforators, resulting in a thin, pliable, ALT adipofascial free flap (ALTAF).To date, there have been few case series and case reports 3-6 describing the use of ALTAF in the head and neck. We now have several years of experience with this flap for mucosal reconstruction and have used it for oral cavity reconstruction, including palate, gingival, tongue, and buccal mucosa reconstruction. We also have used the flap in nasal lining reconstruction. 7 In this article, we review the straightforward harvest of the ALTAF and highlight our experience with the versatile indications and some contraindications for use of this flap. MethodsAll patients undergoing free tissue transfer at the Cleveland Clinic, Cleveland, Ohio, between January 1, 2009, and June 30, 2013, were reviewed, and those undergoing ALTAF for muco-IMPORTANCE This study describes a reliable technique for mucosal reconstruction of large defects using components of a common free flap technique.OBJECTIVE To review the harvest technique and the varied scenarios in which the anterolateral thigh adipofascial flap (ALTAF) can be used for mucosal restoration in oral cavity and nasal reconstruction. DESIGN, SETTING, AND PARTICIPANTSA retrospective review of the medical records of 51 consecutive patients was conducted. The patients had undergone ALTAF head and neck reconstruction between January 2009 and June 2013. Each case was reviewed, and flap survival and goal-oriented results were evaluated.RESULTS Thirty patients met the inclusion criteria and were included in the analysis. The mean patient age was 60.6 years. Reconstruction sites included the tongue, palate, gingiva, floor of the mouth, and nasal mucosa. All mucosal reconstructions maintained function and form of replaced and preserved tissues. One patient (3%) experienced flap failure that was ...

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The pectoralis major muscle flap without skin in intra-oral reconstruction

Cited by 40 publications

References 8 publications

Pectoralis major myofascial flap: A valuable tool in contemporary head and neck reconstruction

Pectoralis major myofascial flap: A valuable tool in contemporary head and neck reconstruction

The Pectoralis Major Myofascial Flap for Intraoral and Pharyngeal Reconstruction

Anterolateral Thigh Adipofascial Flap in Mucosal Reconstruction

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