Pectoralis major myocutaneous flaps vs. revascularised free tissue flaps following salvage surgery for recurrent head and neck cancer

Author:

Pazdrowski Jakub1,Golusinski Pawel2,Szewczyk Mateusz3,Majchrzak Ewa4,Dańczak-Pazdrowska Aleksandra5,Golusiński Wojciech3

Affiliation:

1. Department of Head and Neck Surgery, Poznan University of Medical Sciences, The Greater Poland Cancer Center, Poznan, Poland

2. Katedra i Klinika Otorynolaryngologii i Chirurgii Szczękowo Twarzowej Uniwersytet Zielona Góra

3. Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej Uniwersytet Medyczny Poznań

4. Uniwersytet Medyczny im. Karola Marcinkowskiego w Poznaniu Wydział Lekarski II Katedra i Klinika Chirurgii Głowy, Szyi i Onkologii Laryngologicznej

5. Department of Dermatology, Poznań University of Medical Sciences, Poznan, Poland

Abstract

Purpose: To assess the efficacy of two reconstructive methods: pectoralis major myocutaneous flap and revascularised free flap in salvage surgery for recurrent head and neck cancer. Patients and Methods: We retrospectively analysed 100 cases of patients who had recurrent head and neck cancer and were treated in the Department of Head and Neck Surgery between 2011 and 2021. The study participants were divided into two groups depending on the method of reconstruction: 62 patients who underwent revascularised free flap reconstruction and 38 patients with pectoralis major myocutaneous flap. Results: In total, flap necrosis was observed in 20 cases, 18 of which were in the group who received revascularised free flaps (29.03%) and 2 in the pectoralis major myocutaneous flap group (5.26%). The OR of flap failure in the free flap group vs. pectoralis major flap group was 7.36 (95% CI 0.85-63.75; p=0.067) In the group who underwent revascularised free flap reconstruction the total surgery time was significantly longer than in the other group (p < 0.0001). Conclusion: We suggest the advantages of using pectoralis major myocutaneous flaps for recurrent head and cancers, which is of the utmost importance for malnourished patients in poor general health and whose primary treatment comprised of a combination therapy.

Publisher

Index Copernicus

Subject

Otorhinolaryngology

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