DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20205620

Utility of island bipaddle pectoralis major myocutaneous flap in reconstruction of full thickness lower gingivo-buccal sulcus defects

Ravi P. Deo, Balan Ashok Kumar, Sagayaraj A., Azeem Mohiyuddin S. M.

Abstract


Background: Aims of the study was to evaluate the usefulness of island bipaddle pectoralis major myocutaneous flap in the reconstruction of through and through lateral gingivobuccal sulcus defects.

Methods: This was a retrospective study carried out from 2013 - 2019 in the department of otorhinolaryngology and head and surgery at Sri Devaraj Urs Medical College and Hospital. After obtaining institutional ethical committee clearance. Sixty-one patients diagnosed with stage IV a lateral Gingivobuccal squamous cell carcinoma with skin involvement and reconstructed using island bipaddle pectoralis major myocutaneous flap were included in the study.  

Results: Majority of our patients were females. Nearly 50% of our patients had skin involvement secondary to Level-I nodal metastasis. Nine patients in our study developed complications. Among them seven patients had minor complications and in two patients the flap failed.

Conclusions: In resource constraint places where microvascular reconstruction facilities are not available and where replacing bone is not mandatory, island bipaddle pectoralis major myocutaneous flap can be used effectively as single stage reconstruction option for full thickness lower gingivo-buccal sulcus defects.


Keywords


Oral cancer, Pectoralis major myocutaneous flap, Reconstruction

Full Text:

PDF

References


Sankaranarayanan R, Ramadas K, Amarasinghe H, Subramanian S, Johnson N. Oral cancer: prevention, early detection, and treatment. In: Gelband H, Jha P, Sankaranarayanan R, Horton S, editors. Cancer: Disease Control Priorities. Third Edition. Washington (DC): The International Bank for Reconstruction and Developmen. The World Bank. 2015:85-100.

Kulkarni MR. Head and neck cancer burden in India. Int J Head Neck Surg. 2013;4:29-35.

Deo SS, Purkayastha J, Das DK, Kar M, Srinivas G, Asthana S, et al. Reconstruction of complex oral defects using bi-paddle pectoralis major flap-technical modifications and outcome in 54 cancer patients. Indian J Otolaryngol Head Neck Surg. 2003;55:5-9.

Sahu PK, Kumar S. Bipaddle pectoralis major myocutaneous flap for single stage reconstruction of oromandibular defects. Indian J Otolaryngol Head Neck Surg. 2019;72:44-8.

Rikimaru H, Kiyokawa K, Watanabe K, Koga N, Nisshi Y, Sakamoto A. New method of preparing a pectoralis major myocutaneous with a skin paddle that include third intercostals perforating branch of the internal thoracic artery. Plast Reconstr Surg. 2009;123:1220-8.

Sagayaraj A, Deo RP, Mohiyuddin SA, Modayil GO. Island pectoralis major myocutaneous flap: an Indian perspective. Indian J Otolaryngol Head Neck Surg. 2012;64:270-4.

Freeman J, Walker E, Wilson J, Shaw H. The vascular anatomy of the pectorals major myocutaneous flap. Br J Plast Surg. 1981;34:3-10.

Bhathena HM, Kavrana NM. The folded, bipaddled pectoralis major composite flap in oral reconstruction. Br J Plast Surg. 1989;42:441-6.

Ahmad QG, Navadgi S, Agarwal R, Kanhere H, Shetty KP, Prasad R. Bipaddle pectoralis major myocutaneous flap in reconstructing full thickness defects of cheek: a review of 47 cases. J Plast Reconstr Aesthet Surg. 2006;59:166-73.