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The pectoralis major myocutaneous flap: applications and complications in head and neck reconstruction.

Ninety-six pectoralis major myocutaneous flaps were used in the head and neck reconstruction of 93 patients who underwent extirpation of cancer. The utilization of the pectoralis major myocutaneous flap included 50 tongue replacements, 19 hypopharynx and pharyngoesophageal closure, 11 oral mucosal closure and external skin replacement, 7 soft tissue coverage of the reconstruction plate, 3 soft tissue protection of the great vessels at the neck and 6 correction of the wound breakdown from failure of the other flap reconstruction. The major complication, which included total flap loss, partial skin paddle loss, orocutaneous fistula, dehiscence and plate exposure, was 17.7%. The overall complication rate was 54.2% and most of them were healed by conservative management. The pectoralis major myocutaneous flap is feasible and reliable for immediate reconstruction of various defects in the head and neck area. The pectoralis major myocutaneous flap should be the suitable flap for the advanced-staged cancer patient with a limited life expectancy.