Regeneration, Reconstruction & Restoration (Triple R)

Abstract

Introduction: The aim of the present study was to evaluate outcomes and complications related to pectoralis major mayocutaneous (PMM) flaps in the reconstruction of maxillofacial defects.

Materials and Methods: Subjects who underwent pectoralis major mayocutaneous flaps to reconstruct maxillofacial defects due to trauma or tumor resection were studied. Complications were considered in two stages: early and late. A modified version of the University of Washington Quality of Life questionnaires, version 4, was used to evaluate the functional outcome of patients who underwent free flap or PMM flap reconstruction. The survey is composed of 6 domains: pain, appearance, activity, swallowing, chewing, and speech. We scored domains on a scale ranging from 0 (worst) to 100 (best). We considered scores higher than 70 in the normal range for appearance, activity, swallowing, chewing, and speech.

Results: Thirty-one subjects were studied. The most common defect sites were oral floor (48.3%) and buccal soft tissue (32.2%). The least common was neck (19.3%). Immediate complications consisted of dehiscence in 3 cases (9.6%) and flap necrosis in 2 cases (6.4%). Late complications included dehiscence in 3 cases, partial necrosis of skin without muscle necrosis in 1 case, and donor site infection in one case. The most common complications seen in both stages were dehiscence (19.3%) and necrosis (9.6%).In the immediate phase, patients mostly complained of pain. In the late stage, pain significantly decreased. Activity, swallowing, and speech improved in the late stage.

Conclusion: Our study indicated a significant improvement in patients' functional outcomes after discharge from the hospital. The pain was a major complaint of patients immediately after reconstruction with PMM flap, which should be considered as a significant concern for maxillofacial surgeons.