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Evaluating the Success of Pectoralis Major Myocutaneous Flap in Mandibular Reconstructions in Relation to Defect Localization

  • ORIGINAL RESEARCH
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Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Objectives

In this study, the success of mandibular reconstructions with pectoralis major myocutaneous flaps (PMMF) was assessed based on the location of the defect.

Materials and Methods

The data obtained from patients who had previously undergone PMMF reconstruction during a 3-year period, from 2018 to 2021, was retrospectively analyzed using predetermined criteria (postoperative complications, flap survival). Cases included were treated using Urkens’ technique at the Istanbul Sultan 2. Abdulhamid Han Training and Research Hospital of the University of Health Sciences, defects were classified according to Browns’ classification.

Results

18 individuals, ages ranging from 28 to 82 (M: 59.05) with differing diagnoses (squamous cell carcinoma [SCC] [n = 11], myoepithelial carcinoma [MEC] [n = 1], osteosarcoma [n = 3], medication-related osteonecrosis [MRONJ] [n = 2], gunshot wound [n = 2]) were chosen for the analysis. Based on Browns’ classification, 8 defects were noted to be Class I, while the remaining 4 and 6 were classified as class II and class III, respectively. Postoperative complications in class III cases included partial necrosis (n = 4), orocutaneous fistula (n = 3), wound dehiscence (n = 2) and plate exposure (n = 3). No major postoperative complications occurred in class I and majority of the class II defects. Class I cases had a 100% success rate (n = 8), while the reconstruction of class III defects had a significantly lower success rate, with only 1 of the 6 cases considered successful. Compared to Class III, the class II cases had a relatively high success rate (75%, n = 3), one of the cases being considered unsuccessful.

Conclusion

In comparison with class I and II, Class III defects involving the anterior mandible were found to have a higher rate of complications. This difference in clinical outcome is thought to be associated with decreased flap vascularity stemming from the arc of rotation. Utilizing free flaps will provide a better clinical outcome in aforementioned defects; thus, in Class III defects, PMMF should be preferred when free flaps are contraindicated or as a salvage flap.

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Funding

This research has not received any grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Health Sciences, Selimiye Mah. Tıbbiye Cad. No: 38, 34668, Üsküdar, Istanbul, Turkey

    Goksel Timarcioglu, Ecem Gedik, Utku Bahran & Mert Karacakurtoglu

  2. Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Medipol University, Kavacik, Istanbul, Turkey

    Ozge Sen

  3. Independent Author, Private Practice: Prof. Dr. Celal Candirli, Istanbul, Turkey

    Celal Candirli

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  1. Goksel Timarcioglu
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Contributions

GT was contributed to supervision, validation, writing—review and editing, visualization. OS was contributed to validation, formal analysis, writing—review and editing, visualization. EG was contributed to validation, formal analysis, writing—review and editing, visualization. UB was contributed to writing—review and editing, visualization. MK was contributed to investigation, writing—review and editing, visualization. CC was contributed to conceptualization, methodology, resources, supervision, project administration.

Corresponding author

Correspondence to Ecem Gedik.

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There are no conflicts of interest to disclose for any of the authors herein listed.

Ethical approval and patient consent

University of Health Sciences Scientific Research Ethics Committee provided the ethical approval for present study. The standards within the framework of the Declaration of Helsinki and the Good Clinical Practice Guidelines were complied with [37]. All participants were informed regarding the inclusion of their photographs and data to the study. Following the disclosure process, their signature was obtained on the informed consent form.

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Timarcioglu, G., Sen, O., Gedik, E. et al. Evaluating the Success of Pectoralis Major Myocutaneous Flap in Mandibular Reconstructions in Relation to Defect Localization. J. Maxillofac. Oral Surg. (2024). https://doi.org/10.1007/s12663-024-02126-3

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