大胸筋myocutaneous island flapによる頭頚部領域の再建

概要

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The pectoralis major myocutancous island flap was used for head and neck reconstruction in six patients. Reconstruction was made on five of the patients following extirpative surgery of the oral cavity. The flap was also used in one patient for the reconstruction of a large defect in the submandibular region due to radiation necrosis. No loss resulted in any portion of the flaps in any of the patients. No complications were encountered.The advantages of the pectoralis major myocutancous island flap are as follows. The flap has an excellent blood supply and is very reliable. Reconstruction can be performed in one stage. Large defects of tissue can be filled with the thick skin-subcutaneous-muscle complex. The muscle pedicle protects the carotid artery and restores the contour to the dissected neck. There is usually no need of skin grafting to the donor site.The disadvantages of this flap are as follows. The thickness of the flap limits its use only to large tissue defects. The flap is problematic in cases with thick subcutaneous fat and muscle. The loss of the function of the pectoralis major muscle is inevitable. The bulkiness of the musule pedicle covering the neck has the potential of obscuring recurrent neck disease.Although, this flap will probably become more commonly used, there may still be cases in which regional or other skin flaps are preferable to this flap.
耳鼻咽喉科臨床学会の論文