BipaddlePectoralis Major Myocutaneous Flap for oral cancer

Purpose: The Bipaddle pectoralis major myocutaneous flap (PMMF) is a commonly used flap in reconstructive head and neck surgery in advanced cases, but in literature, the flap is also associated with a high incidence of complications in addition to its large bulk. The purpose of the study is the evaluation of the flap reliability, operative technique and outcome in reconstructive head and neck cancer surgery. Patients and methods: The records of all patients treated with a bippadle PMMF between 2012 and 2015 were systematically reviewed. Data of recipient localization, main indication, operative technique, postoperative complications and outcomes were analyzed. Major complications were evaluated if revision surgery was necessary and minor ones if conservative wound care alone was required. Results: The male to female ratio was 4.6:1, with a mean age of 51 years (45-64). PMMF reconstruction was done in all patients of advanced squamous cell carcinoma of oral cavity. In 3 female patients (10.7%), minor flap related complications were seen, however recovered well with acceptable final outcome. Conclusion: The Bipaddle PMMF is reliable for large defects in head and neck reconstructive surgery, particularly when a bulky flap is needed and the lesion is involving the outer skin. Placing the flap horizontally with inclusion of nipple and areola in most of the patients increased the reach and size of available flap.