구강암 절제후 대흉근 근피판을 이용한 악안면 재건술의 임상적 고찰

The pectoralis major myocutaneous flap for reconstruction of marillofacial defects after surgical ablation of oral cancer

The authors studied 22 patients in whom a pectoralis major myocutaneous flap was used for reconstruction of maxillofacial defect after surgical ablation of oral cancer, and the results obtained were as follows; 1. The most oral cancer was squamous cell carcinoma(81.8%) and the major type of TNM classifiation was T₂NoMo(31.8%). 2. Most of all reconstruction sites were intraoral defects(81.8%) as following orders; gingiva(31.8%), buccal mucosa(18.2%), tongue(18.2%), floor of mouth (13.6%), soft palate(9.1%), retromolar pad(9.1%). The mean size of the skin flap was 7.2×9.0㎝. 3. The pectoralis major myocutaneous flap covered carotid artery in 17 RND cases(77.3%), and metal plate which was temporary substitute of the resected mandible(27.3%), and there was no complication. But the pectoralis major osteomyocutaneous flap with rib seemed to be lack of reliability for reconstruction of the madible. 4. The pectoralis major myocutaneous flap can be used combined with other flap such as sternocleidomastoid(13.6%), cervicopectoral(9.1%), cervicofacial(4.5%), trapezius myocutaneous flap(4.5%), and skin grafts(18.2%). 5. The complications were orocutaneous fistula(9.1%), dehiscence(9.1%), infection(4.5%), partial necrosis(4.5%), and total necrosis(4.5%) in 6 cases(27.3%). 6. It would be appear that the pectoralis major myocutaneous flap is a reliable method and its complications can be reduced by tension-free design and good blood supply to the flap.