PEDICLED AND MICROVASCULAR FREE FLAPS FOR RECONSTRUCTIONS IN THE HEADAND NECK REGION

The introduction of the pectoralis major myocutaneous flap has opened up new dimensions for reconstruction following radical resection of ad vanced oral and pharyngeal malignancies. We report our 12-year experie nce with 89 patients in whom reconstruction with a pectoralis major fl ap was performed. The advantage of this technique is that it involves a single-stage reconstruction; moreover, the carotid artery is protect ed after neck dissection and soft tissue defects can be remodelled wit h the added bulk of the myocutaneous flap. On the other hand, the appl icability of the technique is limited by the rigidity of the flap and the length of the vascular pedicle. These problems were solved by free tissue transfer. The excellent functional and aesthetic results of re anastomosed transplants have led to the myocutaneous pectoralis major flap being replaced at the Department of Otolaryngology in Tubingen.