Submammary Approach for Harvesting Pectoralis Major Myocutaneous Flap in Females with Oral Cavity Cancers: Report of Technique and Our Experience

Durgesh Kumar; Indu Shukla; Ankur Verma; Ashok Kumar Singh

doi:10.1007/s12663-023-01984-7

Submammary Approach for Harvesting Pectoralis Major Myocutaneous Flap in Females with Oral Cavity Cancers: Report of Technique and Our Experience

J Maxillofac Oral Surg. 2024 Feb;23(1):44-48. doi: 10.1007/s12663-023-01984-7. Epub 2023 Aug 4.

Authors

Durgesh Kumar¹, Indu Shukla², Ankur Verma¹, Ashok Kumar Singh¹

Affiliations

¹ Department of Surgical Oncology, Kalyan Singh Superpeciality Cancer Institute, C.G. City, Lucknow, India.
² Department of ENT, Kalyan Singh Superspeciality Cancer Institute, C.G. City, Lucknow, 226002 India.

PMID: 38312980
PMCID: PMC10830988 (available on 2025-02-01)
DOI: 10.1007/s12663-023-01984-7

Abstract

Background: Oral squamous cell carcinoma is one of the most common types of cancers affecting both male and female population worldwide. Currently gold standard for reconstruction of oral cavity defects is free flap reconstruction. However, in developing countries due to large case load, infrastructural and resource constraints, Pectoralis major myocutaneous flap is still widely being used. Harvesting PMMC flap in females is challenging due to thick fat and breast tissue affecting its reliability and also increased donor site morbidity. This article aims at highlighting our experience with harvesting PMMC flap in female patients by submammary approach and its outcomes.

Methods: A total of 23 female patients who underwent wide local excision of oral cavity cancers and reconstruction with PMMC flap were included. Data was analysed as mean, median, mode, percentages and statistical averages.

Results: Majority of patients belonged to 40-60 years of age group (60.86%). Buccal mucosa was the most common site of primary lesion in 16 patients (69.56%). Out of the 23 patients who underwent PMMC flap reconstruction, recipient site complications were seen in 4 patients including total flap loss in 2 patients (8.69%), minor complications, e.g. infection in 2 patients (8.69%). Donor site morbidity in the form of axillary seroma was seen in only 1 patient (4.34%).

Conclusion: In our experience, PMMC flap is still a viable option for reconstruction especially in resource constraint settings. Submammary approach to PMMC flap harvest is a safe technique as it is associated with minimum recipient site complications whilst preserving donor site anatomy and thereby reducing donor site morbidities to minimum.

Keywords: Female PMMC; Oral cancer; Pectoralis major myocutaneous flap; Submammary; Surgical technique.

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