Comparison between functional pectoralis major myocutaneous flap and conventional flap in oral cancer patients
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ORIGINAL PAPER
Comparison between functional pectoralis major myocutaneous flap and conventional flap in oral cancer patients Rohit Mittal 1 & Majid Ahmed Talikoti 1,2 & Saurav Kumar 1 & Vipul Sud 1 Received: 11 June 2020 / Accepted: 1 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Background Pectoralis major myocutaneous (PMMC) flap has been the workhorse of reconstruction in oral cancer patients. However, it does have a deleterious effect on the patient’s speech, food ingestion and overall cosmetic appearance. ‘Functional PMMC flap’ reconstruction had been introduced in the 1990s for ameliorating these problems but has not gained documented popularity over the last 3 decades. The purpose of the study was to evaluate the aesthetic and functional advantage of a modified functional PMMC flap over conventional PMMC flap. Methods As both harvesting techniques of PMMC flaps were being done for a long period at our hospital, an observational study of 50 patients was conducted, patients were followed over a period of 1 year at 3 month intervals. The criteria of assessment for the categories of speech, food ingestion and appearance were kept simple and easily reproducible. Overall scores were compared. Complications in the immediate post-operative period in both groups were also assessed. Results Aesthetic and functional assessment scores were observed to be statistically significant in the functional PMMC group as compared with those in conventional PMMC flap throughout the 1-year period. No complications were recorded in the functional PMMC group in the immediate post-operative period. Conclusions Our observations confirm that functional PMMC flap provides more acceptable aesthetic and functional outcome over conventional PMMC flaps with no complications. We advocate its primary use in certain settings especially where access to microsurgical techniques is absent. Level of evidence: Level III, therapeutic study. Keywords Functional pectoralis major myocutaneous flap . Oncologic reconstruction . Head and neck cancer . Islanded pedicle flap
Introduction Oral cancers in the Indian subcontinent constitute the most common form of head and neck cancer [1, 2]. It more often affects the lower socio economic groups, partly being due to exposure to smokeless tobacco and alcohol [3], factors contributing to increased incidence. The majority of such patients are diagnosed late due to lack of awareness regarding treatment and its prohibitive cost, especially in developing countries. As all such cancers
* Vipul Sud [email protected] 1
Batra Hospital & Medical Research Centre, 1,Tuglakhabad Institutional Area, Mehrauli Badarpur Road, New Delhi 110068, India
2
Department of General Surgery, Rama Medical College & Research Centre, Mandhana, India
require reconstruction, they often need a robust as well as economically affordable option. Reconstruction in such patients is mostly done with pedicled pectoralis major myocutaneous (PMMC) flap. Although it continues to be the workhorse of reconst
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