A long-term follow-up of pectoralis osteomyocutaneous flaps.

Overview

Reconstruction of the arch of the mandible has always been a difficult problem. The problem of reconstruction is compounded by bony defect and also the loss of soft tissue after resection of tumors of the floor of the mouth. A variety of different methods have been utilized for immediate and delayed reconstruction of the arch of the mandible with limited success. There are various post-operative complications and problems related to infection, soft tissue loss, and recurrence of the tumor. A free microvascular reconstruction is considered the best and the state of the art. However, it requires specialized training and expertise in microvascular surgery. Other methods have been successful, such as the pectoralis myocutaneous flap, pectoralis osteomyocutaneous flap, K wire, Steinman pin, and trapezius osteomyocutaneous flap. We have utilized the pectoralis osteomyocutaneous flap in six instances. Two of these patients have been followed for a long time, ranging from 7-8 years and we have noticed certain changes in the soft tissue and the rib. We are reporting here the long term results of the two patients who are alive from 7-8 years. The major finding in these patients was rib resorption and deteriorating cosmetic appearance and development of "Andy Gump" deformity.