Efficacy of myofascial pectoralis major muscle flap in reconstruction post-salvage laryngectomy

Abstract

Background: The pectoralis major muscle flap (PMMF), a reliable muscle-based flap, offers a viable solution for reconstructing laryngeal defects, aiming to restore function and improve postoperative outcomes. This work assessed the efficacy of the myofascial PMMF in reconstruction post-salvage laryngectomy. Methods: This is a prospective study for cases who underwent salvage total laryngectomy (STL) and reconstruction by myofascial PMMF for recurrent tumors post-radio(chemo)therapy in the National Cancer Institute, Cairo, Egypt, in a period from January 2019 to December 2020. Patients were followed up for one year. Results: Twelve male patients were included in this prospective study, aged 18-65 years. Pharyngocutaneous fistula (PCF) occurred in 4 (33.33%) patients, it was minor in 2 (16.67%) patients. Bleeding was diagnosed in 2 (16.67%) patients, one (8.33%) of them died. Wound infection and dehiscence were recorded in 1 (8.33%) patient. Tumour recurrence was recorded in 4 (33.33%) patients. Five (41.67%) patients died. Diabetes mellitus (DM) was significantly higher in patients with bleeding than in patients without bleeding (P =0.015). Conclusions: The myofascial PMMF demonstrated its efficacy as a reconstructive method following STL, providing reliable closure of defects. DM was found to influence postoperative bleeding.