Maxillofacial Plastic and Reconstructive Surgery

  • 제35권5호
  • /
  • Pages.277-283
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  • 2013
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  • 2288-8101(pISSN)
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  • 2288-8586(eISSN)
대한악안면성형재건외과학회 (Korean Association of Maxillofacial Plastic and Reconstructive Surgeons)
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구강악안면 영역의 재건을 위한 대흉근피판의 임상적 평가

Evaluation of the Pectoralis Major Myocutaneous Flap for Oral and Maxillofacial Reconstructive Surgery

  • 나광명 (경북대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김진욱 (경북대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 이호진 (경북대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 김진수 (경북대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 권대근 (경북대학교 치의학전문대학원 구강악안면외과학교실) ;
  • 이상한 (경북대학교 치의학전문대학원 구강악안면외과학교실)
  • Na, Kwang Myung (Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry) ;
  • Kim, Jin-Wook (Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry) ;
  • Lee, Ho-Jin (Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry) ;
  • Kim, Chin-Soo (Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry) ;
  • Kwon, Tae-Geon (Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry) ;
  • Lee, Sang-Han (Department of Oral and Maxillofacial Surgery, Kyungpook National University School of Dentistry)
  • 투고 : 2013.02.26
  • 심사 : 2013.08.27
  • 발행 : 2013.09.30
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초록

Purpose: Well vascularized pectoralis major myocutaneous flap (PMMF) had been a commonly used versatile flap in reconstructive oromaxillofacial surgery since the 1970s. However, after the advent of microvascular surgery in the 1980s, the PMMF was used less frequently. But, to date, PMMF has been useful and has some advantages such as covering wide defects, covering vital structures, back-up procedure in cases of free flap failure, and reconstruction for radiotherapy patients. The purpose of this study is to evaluate the role, indication, complications, functional, and aesthetic results of this flap in the era of free flap with a literature and chart review. Methods: A retrospective study was conducted of 16 oral cancer patients undergoing reconstructive surgery with PMMF for reconstruction of defects from 2001 to 2012 at Kyungpook National University Hospital. The male to female ratio was 10:6, with a mean age of 63 years (16~79 years). Basic demographic data, previous treatment history, indications, dimension of the flap, site of reconstruction, postoperative complications, and patients' final status were systemically analyzed from chart review. Results: The pathology of the disease included squamous cell carcinoma in the majority of cases (n=14). The remaining cases were fibrosarcoma and mucoepidermoid carcinoma. Of the 16 PMMF reconstructions, 13 flaps were applied as primary reconstructive procedures, whereas three flaps were; salvage; procedures (vascularized free flap failure). Twelve patients had complications such as wound dehiscence, infection, hematoma, fistula, flap bulkiness, and partial flap necrosis. The higher complication rates showed an association with utilization of the flap in preoperative radiotherapy cases. However, all patients were discharged without failure. Conclusion: In reconstructive oromaxillofacial surgery, the PMMF is still a useful flap for huge defects. In addition, the PMMF can be used as a salvage procedure after vascularized free flap failure and reconstruction for patients with a history of preoperative radiotherapy.

키워드

참고문헌

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