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Pectoralis major myocutaneous flaps vs. revascularised free tissue flaps following salvage surgery for recurrent head and neck cancer

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Pazdrowski J., Golusinski P., Szewczyk M., Majchrzak E., Dańczak-Pazdrowska A., Golusiński W.
Polish Journal of Otolaryngology
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2022
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vol. 76
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issue 5
22-28
EN
Introduction: Pectoralis major myocutaneous flaps (PMF) were introduced in the early 1970s and were widely used in head and neck reconstructions following ablative surgical treatment of advanced tumors located in multiple anatomical subsites. Aim: To assess the efficacy of two reconstructive methods: pectoralis major myocutaneous flap and revascularised free flap in salvage surgery for recurrent head and neck cancer. Material and methods: We retrospectively analysed 100 cases of patients who had recurrent head and neck cancer and were tre- ated in the Department of Head and Neck Surgery between 2011 and 2021. The study participants were divided into two groups depending on the method of reconstruction: 62 patients who underwent revascularised free flap reconstruction, and 38 patients with pectoralis major myocutaneous flap. Results: In total, flap necrosis was observed in 20 cases, 18 of which were in the group that received revascularised free flaps (29.03%) and 2 in the pectoralis major myocutaneous flap group (5.26%). The OR of flap failure in the free flap group vs. pectoralis major flap group was 7.36 (95% CI 0.85–63.75; P = 0.067). In the group that underwent revascularised free flap recon- struction the total surgery time was significantly longer than in the other group (P < 0.0001). Conclusion: We present the advantages of using pectoralis major myocutaneous flaps for recurrent head and cancers, which is of the utmost importance for malnourished patients in poor general health whose primary treatment comprised of combination therapy.
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