Continuous Validity of Pedicled Myocutaneous and Myofascial ... - NCI

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Continuous Validity of Pedicled Myocutaneous & Myofascial Flaps
regions not reached by the pectoralis major or
in women in whom prevention of distortion of
the breasts is desirable. The main disadvantage
of this flap is the need to change the position
in some cases to the lateral decubitus position
during surgery.
The temporalis muscle was used in facial
reconstruction for more than 100 years. Many
surgeons use the temporalis muscle for various
defects in the craniomaxillofacial region. It has
some limitations because of its pedicle. It cannot
reach the midline defects of the face, only a
small volume of the muscle can reach the defect,
and most of the muscle bulk is used in the
pedicle [37].
In our study the temporalis muscle flap was
used in 12 cases. It was effective in reconstructing
the lower or lateral orbital wall defects in
8 cases to support the eye globe. Other effective
indications was to cover the dura in the orbital
roof defect and to facilitate the use of eye
prosthesis after orbital exenteration.
Conclusion:
Pedicled myocutanous and myofascial flaps
are still indicated in composite head and neck
reconstruction. Their reliability, safety, and high
degree of resistance to infection make them
essential specially the (PMMC) flap previously
described as the spare wheel of head and neck
reconstructive surgery. It is suitable for lateral
mandibular defects in edentulous patients and
in partial pharyngeal defects in irradiated patients.
Other pedicled myocutaneous flaps are
still valid in certain occasions and sites. Surgeons
must be acquainted with the different
pedicled myocutaneous flaps that could be used
for head and neck reconstruction. The proper
choice of the type of flap that suites every case
and the proper surgical technique got by experience
will give the best functional and aesthetic
results with the least morbidity.
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