Purpose: The purpose of this study was to compare Pectoralis major myocutaneous flap (PMMC) and Free flaps for reconstruction of post ablative defects in patients undergoing treatment for oral squamous cell carcinoma and to understand the reasons for choosing each from a developing nation perspective.
Material And Methods: In the present study, a retrospective study was conducted of the patients treated by either free flaps or PMMC flaps for reconstructive procedures over a five year period in the Department of Oral and Maxillofacial Surgery, Shri Guru Ram Das Institute of Dental Sciences and Research.
Results: Out of 90 PMMC flaps, 44 patients (48.8%) had reconstruction due to lack of micro vascular facility at the center, in 39 patients (43.3%) due to financial constraints and in 7 patients (7%) due to associated comorbities. The overall complication rate in PMMC group was 30% as compared to 28% in Free Flap group. Total flap loss was seen in 3 flaps (2 microvascular and 1 PMMC) while marginal necrosis of skin paddle was seen in 12 patients (13%) in the PMMC group.
Conclusion: Though, the selection of PMMC flap over free flap was influenced by many factors, results of this study suggest that PMMC flap still has a major role in post-ablative defect reconstruction even in this era of free flaps, especially in developing countries like India.
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http://dx.doi.org/10.1016/j.jobcr.2022.08.028 | DOI Listing |
Indian J Otolaryngol Head Neck Surg
December 2024
Department of Surgical Oncology, Shri Guru Ram Rai Institute of Medical and Health Sciences, Patel Nagar, Dehradun, 248001 India.
Oral cancer often presents in advanced stages, requiring complex surgical interventions. The bipedal pectoralis major myocutaneous (PMMC) flap is a commonly used alternative to the gold standard free flaps for reconstruction in resource-constrained settings. However, large donor sites may necessitate split-thickness skin grafting (STSG), leading to aesthetic challenges.
View Article and Find Full Text PDFIndian J Otolaryngol Head Neck Surg
December 2024
HCG Manavata Cancer Centre, Nashik, India.
Segmental resections of the mandible may cause severe functional and aesthetic problems due to continuity loss. The morbidity after mandibular resection can be minimized after microvascular transfer of vascularized bone grafts. Although free flaps have become the gold standard in the past decades for reconstruction of oral cavity defects, regional flaps can also be a reliable option in certain cases, especially for those belonging to the lower socioeconomic corridor and or with coexisting chronic comorbidities which will not allow lengthier procedures.
View Article and Find Full Text PDFIndian J Surg Oncol
September 2024
Department of Robotics and Surgical Oncology, HCG Manavata Cancer Centre, Near Mylan Circle, Mumbai Naka, Nashik, Maharashtra 422002 India.
The severe complication in oral cancer patients receiving radiation therapy is osteoradionecrosis. The reported incidence of ORN is highly variable, ranging from 0 to 37.5%.
View Article and Find Full Text PDFIndian J Otolaryngol Head Neck Surg
August 2024
Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh India.
Present study is a comparative evaluation of the financial impact on choice of flap, clinical results as well as post resection quality of life assessment of cancer patients reconstructed with anterolateral thigh(ALT) flap and pectoralis major myo-cutaneous(PMMC) flap. Ethical clearance was obtained from institutional ethical committee. In this non-randomised, prospective study design among 49 oral squamous cell carcinoma cases, 39 cases were reconstructed using PMMC flap and 10 using ALT flap from year 2020 to 2022.
View Article and Find Full Text PDFJ Maxillofac Oral Surg
August 2024
Department of Head and Neck Surgery, Advanced Centre for Treatment, Research and Education in Cancer, Tata Memorial Hospital, Homi Bhabha National Institute, PS Building, ACTREC, Kharghar, Navi Mumbai, Mumbai, Maharashtra 410210 India.
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