Folded pectoralis major myocutaneous flap for complex oromandibular defects: A case report with surgical technique

Oral cancer presenting in late stages requires extensive resection and mandibulectomy. Ideal reconstructive options for such defects are composite-free flaps so as to provide outer skin covering and bridge the mandibular defect. The availability of expertise and resources for such complex reconstructive surgeries is a setback. The predominant alternative in these cases is the use of the workhorse flap, the pectoralis major myocutaneous (PMMC) flap; there are several modifications proposed since the flap was first described. The most common modification, which is used, is bipaddle PMMC which carries an increased risk of complications. Here, we present a modification of PMMC flap for reconstruction of complex defects created after resection of buccal mucosa, mandible, and cheek skin with lesser complications and without the need for free flaps.