Clinical Evaluation of the Pectoralis Major Flap for Reconstruction in Head and Neck Cancer

Sixty two patients (7 women and 55 men) with head and neck cancer underwent 64 musculocutaneous or osteomusculocutaneous reconstructions in the Department of Head and Neck Tumours, Estonian Cancer Centre, from May 1988 to December 1991. Two men had two reconstructions. The patients were evaluated for surgical, functional, aesthetic, and also for oncological results. The flap-related complication rate was higher among women than men (6/7 (86%) compared with 19/57 (33%), p = 0.012), and in the group of osteomusculocutaneous flaps which contained a segment of the fifth or sixth rib compared with the musculocutaneous ones (5/6 (83%) compared with 20/58 (34%), p = 0.03). The functional results were good or satisfactory in 41/60 (68%) of the cases. Mean follow-up time was 32 months; 31/58 (53%) of patients operated on due to primary or recurrent cancer are alive, with or without recurrent disease. We do not recommend the inclusion of rib segments in pedicled pectoral flaps for reconstructions of head and neck defects.