Myocutaneous v/s micro vascular free flaps in oral cavity reconstruction - a comparative study

  • Umanath K. Nayak
  • Bharatendu Swain
Main Article


Micro vascular free tissue transfer scores over the traditional myocutaneous flaps by providing better cosmesis and function. However, the increased operating tine and costs and the necessity for two operating teams sometimes, negate these advantages and even where this facility is freely available, myoentancous flaps continue to be widely used.

To determine the ideal choice of reconstruction in patients after oral resection, we compared our experience with these two methods of reconstruction. Since 1997, when we first started micro vascular reconstruction, 17 patients have undergone this procedure for oral reconstruction. During this same period, 40 patients had pectoralis major myocutaneous flap reconstruction of the oral cavity. These two groups are compared with regard to cosmetic and functional results (as measured by patient’s level of satisfaction) operating time, duration of hospitalization, cost and complications.

Results: Eightv seven percent of the patients in the micro vascular group and 75% in the myocutaneous group were satisfied with the cosmetic and functional results. In the microvascular group, average operating time was increased by 4 hours; hospitalization by 3 days and average cost of treatment was doubled. Flap failures and re-explorations were significantly higher in the micro vascular group.

Based on these results, we would like to suggest the ideal method of reconstruction of the oral cavity in specific subgroups of patients in a corporate hospital setting.

Key Words

Myocutaneous flaps Micro vascular free flaps Oral cavity Reconstruction 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Ariyan S (1979) The pectoralis major myocutaneous flap A versatile flap for reconstruction in the Head & Neck Plastic reconstructive surgery 63 73–81Google Scholar
  2. 2.
    Bakamjain VY Long M Rigg B (1971) Experience with the medially based deltopectoral flap in reconstructive surgery of the Head & Neck British Journal of Plastic Surgery 24 174–183CrossRefGoogle Scholar
  3. 3.
    Soutar DS SchekarLR Tanner NSB et al (1983) The radial forearm flap A versatile method for intraoral reconstruction British Journal of Plastic Surgery 36 1–8PubMedCrossRefGoogle Scholar
  4. 4.
    Hidalgo DA (1991) Aesthetic improvements in tree flap mandible reconstruction Plastic Reconstructive Surgery 88 574–585CrossRefGoogle Scholar
  5. 5.
    Urken ML (1991) Composite free flaps in oro mandibular reconstruction Archives of Otolaryngology Head & Neck Surgery 117–724Google Scholar
  6. 6.
    Schustermann MA Shestak K Devries EJ et al (1990) Reconstruction of the cervical esophagus Free jejunal transfer Vs Gastric pull up Plastic Reconstructive Surgery 85 16–21Google Scholar
  7. 7.
    Urken M Buchbinder I Weinberget al (1991) Functional evaluation following micro vascular oromandibular reconstruction of the oral cancer patient A comparative study of reconstructed and non reconstructed patients Laryngoscope 101 935–950PubMedGoogle Scholar
  8. 8.
    Ariyan S (1979) Further experience with the pectoralis major myocutaneous flap for immediate repair of defects from excision of head & neck cancers Plastic Reconstructive Surgery 64 605–612Google Scholar
  9. 9.
    Shah JP Haribhakti Loree TR et al (1990) Complications of the pectoralis major myocutaneous flap in head & neck reconstruction American Journal of Surgery 160 352–355PubMedCrossRefGoogle Scholar
  10. 10.
    Gal TJ Futran ND (2002) Outcomes of research in Head & Neck reconstruction Facial Plastic Surgery 18 11–17CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2004

Authors and Affiliations

  • Umanath K. Nayak
    • 1
  • Bharatendu Swain
    • 1
  1. 1.Apollo HospitalsHyderabad

Personalised recommendations