Pectoralis Major Rib Osteomyocutaneous Flap in Primary Mandibular Reconstruction for Oral Cavity Carcinoma in Geriatric Population: Is it Better than Fibular Free Flap?
Nitin Khunteta
Keywords :
Comorbidity, Free tissue flaps, Geriatric, Head and neck neoplasm, Hemi-mandibulectomy, Oral cavity cancer, Pectoralis major rib osteo myocutaneous flap (PMROC), Postoperative complications
Citation Information :
Khunteta N. Pectoralis Major Rib Osteomyocutaneous Flap in Primary Mandibular Reconstruction for Oral Cavity Carcinoma in Geriatric Population: Is it Better than Fibular Free Flap?. J Mahatma Gandhi Univ Med Sci Tech 2018; 3 (1):17-20.
Oral cavity cancer in geriatric population is amongst the common cancer seen in our part of world. Squamous Cell Carcinoma is the commonest histology. Generally they come with locally advanced cancer, with multiple comorbid conditions. The morbidity of Radical resection and osteomyo cutaneous free flap reconstruction is higher than younger age group. This high morbidity can lead to mortality also in this age group.
One stage reconstruction of the mandible with soft tissue of the oral cavity and face with pectoralis major Rib osteomyocutaneous (PMROC flap) pedicle flap is one of good option than free flap. PMROC Flap reconstruction is a shorter duration procedure, less morbidity, good cosmetic and functional outcome.
In this article we will discuss our experience of four cases.
Relationships of comorbidities and old age with postoperative complications of head and neck free flaps: A review. Kun Hwang, Jin Pyo Lee, Si Yoon Yoo, Hun Kimx Kun Hwan. DOI: http://dx.doi.org/10.1016/j.bjps.2016.08.018. Published online: September 08, 2016.
Fentiman IS, Tirelli U, Monfardini S, et al. Cancer in the elderly: why so badly treated? Lancet. 1990;335:1020-1022.
Kennedy BJ.Aging and cancer. Oncology. 2000;14:1731-1733.
Balducci L, Beghe C.Cancer and age in the USA. Crit Rev Oncol Hematol. 2001;37:137-145.
Repetto L, Comandini D, Mammoliti S. Life expectancy, comorbidity and quality of life: the treatment equation in the older cancer patients. Crit Rev Oncol Hematol. 2001;37:147-152.
Olmi P, Ausili-Cefaro G. Radiotherapy in the elderly: a multicentric prospective study on 2060 patients referred to 37 Italian radiation centers. Ray. 1997;22:53-56.
Koch WM, Patel H, Brennan J, Boyle JO, Sidransky D. Squamous cell carcinoma of the head and neck in the elderly. Arch Otolaryngol Head Neck Surg. 1995;121:262-265.
Pignon T, Horiot JC, Van den Bogaert W, Van Glabbeke M, Scalliet P. No age limits for radical radiotherapy in head and neck tumours. Eur J Cancer. 1996;32:2075-2081.
Y He, SF Jin, HG Zhu, YX Zhang, ZY Zhang. Reconstruction of composite oromandibular defects with a rib-major pectoralis myocutaneous flap carrying costal parietal pleura: a forgotten option? Annals of Oral & Maxillofacial Surgery 2013 Aug 01;1(3):24.
Hwang K, Lee JP, Yoo SY, Kim H.Relationships Of Comorbidities And Old Age With Postoperative Complications Of Head And Neck Free Flaps: A Review. J Plast Reconstr Aesthet Surg. 2016 Dec;69(12):1627-1635. Doi: 10.1016/J.Bjps.2016.08.018. Epub 2016 Sep 9.
Alberto Grammatica, Cesare Piazza, Alberto Paderno, Valentina Taglietti, Alessandra Marengoni, and Piero Nicolai, Free Flaps in Head and Neck Reconstruction after Oncologic Surgery: Expected Outcomes in the Elderly Otolaryngology– Head and Neck Surgery 2015, Vol. 152(5) 796–802.
N. Brian Shunyu, Jayanta Medhi, Hanifa Akhtar Laskar, Nari Lyngdoh, Judita Syiemlieh, Amit Goyal 5th Rib Osteo-pectoralis Major Myocutaneous Flap—Still a Viable Option for Mandibular Defect Reconstruction. Indian J Otolaryngol Head Neck Surg (Oct–Dec 2014) 66(4):414–417.
