THE MYOFASCIAL PECTORALIS MAJOR FLAP FOR SOFT-TISSUE REPLACEMENT IN THE ORAL CAVITY

Since the original description by Ariyan, the myocutaneous pectoralis- major-(p.m.-)flap has been widely used for soft tissue replacement in the head and neck. In our department this flap has been established as a reliable and versatile method for soft tissue replacement in a vari ety of tumour defects. In the oral cavity a great number of different surgical procedures have been described for reconstruction of soft tis sue defects. However, most surgeons still seem to be using either myoc utaneous p.m.-flaps or the so-called ''free flaps'' (radial forearm fl ap, free jejunal flap). Authors advocating the ''free flaps'' usually emphazise the disadvantages of the myocutaneous p. m.-flap (bulk of ti ssue in the neck and at the recipient site, possible hair-bearing skin , alteration of breast position). During the last two years we have be en adding the myofascial p. m.-flap to our surgical repertoire for sof t tissue replacement in the oral cavity, because of its lack of disadv antages mentioned for the myocutaneous version, Our experience with th e myofascial p. m.-flap for intraoral reconstruction in 14 patients wi th squamous cell carcinomas of the anterior floor of mouth (8) and ton gue (4) are described and discussed in comparison with the ''free flap s'' used in this region.