1. The lateral pectoral composite flap in one-stage reconstruction of the irradiated mandible
- Author
-
John W. Little, David T. McCulloch, and James R. Lyons
- Subjects
Thorax ,Adult ,Male ,Ribs ,Mandible ,Surgical Flaps ,Pectoralis Muscles ,Thoracoacromial artery ,medicine.artery ,medicine ,Humans ,Surgery, Plastic ,Aged ,Maxillary Neoplasms ,Vascular pedicle ,Tumor size ,business.industry ,Pectoralis major muscle ,Carcinoma ,One stage ,Anatomy ,Middle Aged ,Lateral position ,Tongue Neoplasms ,Mandibular Neoplasms ,Carcinoma, Squamous Cell ,Surgery ,business ,Follow-Up Studies - Abstract
We present a composite flap based on the musculature of the anterolateral thorax that allows immediate reconstruction of the mandible through the interposition of vascularized bony fifth rib. While the vascular pedicle remains the pectoral branch of the thoracoacromial artery, the pectoralis major muscle can be spared largely intact. The lateral position of the composite rib segment ensures a purely bony composition, while the lateral skin island remains largely hairless. Despite the unfavorable conditions of massive tumor size and prior irradiation attending the clinical cases presented, the complication rate was acceptable, with only one flap loss, and this followed technical error.
- Published
- 1983