IS THE PECTORALIS MYOCUTANEOUS FLAP IN INTRAORAL AND OROPHARYNGEAL RECONSTRUCTION OUTDATED

METHODS: Our experience with 224 immediate pectoralis major myocutaneo us flap reconstructions in patients with carcinomas of the oral and or opharyngeal cavities is presented. RESULTS: Although flap-related comp lications developed in 53% of the patients, all flaps survived, and we had no major skin paddle loss. The incidence of reoperation due to fl ap-related complications was 2%. All other complications were minor an d did not affect the length of hospitalization. Analysis showed no sig nificant risk factors for the development of complications. Because of fistula formation, infection, or metal exposure, plate removal was ne cessary in 10% of the AO fixation plates used in cases of mandibular s wing. This occurred in 68% of the anterior and 22% of the lateral mand ibular reconstructions performed with a reconstruction plate (P <0.05) . CONCLUSIONS: We conclude that a reconstruction plate is unsatisfacto ry for anterior mandibular continuity reconstruction and debatable for lateral mandibular reconstruction. At present, anterior defects are r econstructed with free vascularized osteocutaneous flaps that should p robably also be used for lateral mandibular reconstruction. Furthermor e, in a targe number of series, it is reported that free flaps also ha ve high complication rates and 5-10% flap loss. As all pectoralis majo r flaps survived in our series, it still remains a good choice in intr aoral and oropharyngeal reconstruction when there is no necessity to r econstruct bone.