The Use of Muscular or Musculocutaneous Pectoralis Major Flap

Abstract

Reconstruction of large parotid defects after extended parotidectomy is common in the field of head and neck surgery. After wide local excision of the primary tumor, regional island flap can often not be used because the defect is too large. In such a situation, reconstruction with a muscular or musculocutaneous pectoralis major flap is a good alternative to free tissue transfer. The pectoralis major flap provides a reliable and ample vascularized soft tissue bulk with skin coverage for defect filling in the parotid area. Its location on the chest wall, the favorable vascular anatomy, and its arc of rotation that is unmatched by any other local flap are other advantages. The pectoralis major flap might also be indicated in cases with failure of a primary reconstruction with a free muscle transfer. After radical parotidectomy needing facial nerve reconstruction, the pectoralis major flap offers a perfect recipient bed to stabilize the facial nerve reconstruction. The special features of defect reconstruction using the pectoralis major flap after extended parotidectomy are presented in this chapter.