Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resection

Introduction: The myocutaneous flap is often used in reconstruction of head and neck defects. However, it is restricted to the middle third of the face. Perforating artery dissection techniques allow further lengthening of the pedicle, thus achieving coverage of the orbitofrontal-parietal region....

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Main Authors: Andres Ordenes Evensen, Daniel Cazeto López, Andrés Fernando Cánchica, Carlos Fernando Goyeneche, Leonardo Gobetti, Renato Giannini, Osvaldo Ribeiro Saldanha
Format: Article
Language:English
Published: Thieme Revinter Publicações Ltda. 2019-03-01
Series:Revista Brasileira de Cirurgia Plástica
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Online Access:http://www.rbcp.org.br/export-pdf/2358/en_v34n1a21.pdf
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author Andres Ordenes Evensen
Daniel Cazeto López
Andrés Fernando Cánchica
Carlos Fernando Goyeneche
Leonardo Gobetti
Renato Giannini
Osvaldo Ribeiro Saldanha
author_facet Andres Ordenes Evensen
Daniel Cazeto López
Andrés Fernando Cánchica
Carlos Fernando Goyeneche
Leonardo Gobetti
Renato Giannini
Osvaldo Ribeiro Saldanha
author_sort Andres Ordenes Evensen
collection DOAJ
description Introduction: The myocutaneous flap is often used in reconstruction of head and neck defects. However, it is restricted to the middle third of the face. Perforating artery dissection techniques allow further lengthening of the pedicle, thus achieving coverage of the orbitofrontal-parietal region. Case report: A 63-year-old male with a poorly-differentiated invasive squamous cell carcinoma presented with a final defect of 12.0 × 18.0 cm in the right orbitofrontal-parietal region, with dura mater, frontal sinus, and right upper orbit exposure after resection. We designed a pectoralis major flap, with a cutaneous island equaling the defect in dimensions, in the right parasternal region, from the fourth intercostal space to the subcostal region (extended). The pedicle was sectioned after 4 weeks. The coverage was effective, with no major complications, and a satisfactory aesthetic result. Conclusion: This flap can be an excellent option for reconstruction of the upper third of the head when there are limitations to microsurgery.
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institution Kabale University
issn 1983-5175
2177-1235
language English
publishDate 2019-03-01
publisher Thieme Revinter Publicações Ltda.
record_format Article
series Revista Brasileira de Cirurgia Plástica
spelling doaj-art-fe059e011f2d40da83f117c8d7647daa2025-08-20T03:58:03ZengThieme Revinter Publicações Ltda.Revista Brasileira de Cirurgia Plástica1983-51752177-12352019-03-01340113814210.5935/2177-1235.2019RBCP0021Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resectionAndres Ordenes Evensen0Daniel Cazeto López1Andrés Fernando Cánchica2Carlos Fernando Goyeneche3Leonardo Gobetti4Renato Giannini5Osvaldo Ribeiro Saldanha6Serviço de Cirurgia Plástica Osvaldo Saldanha, Cirurgia Plástica Reconstrutiva e Estética, Santos, SP, BrazilHospital Santa Casa, Serviço de Cirurgia Plástica, Santos, SP, BrazilServiço de Cirurgia Plástica Osvaldo Saldanha, Cirurgia Plástica Reconstrutiva e Estética, Santos, SP, BrazilServiço de Cirurgia Plástica Osvaldo Saldanha, Cirurgia Plástica Reconstrutiva e Estética, Santos, SP, BrazilServiço de Cirurgia Plástica Osvaldo Saldanha, Cirurgia Plástica Reconstrutiva e Estética, Santos, SP, BrazilServiço de Cirurgia Plástica Osvaldo Saldanha, Cirurgia Plástica Reconstrutiva e Estética, Santos, SP, BrazilServiço de Cirurgia Plástica Osvaldo Saldanha, Cirurgia Plástica Reconstrutiva e Estética, Santos, SP, BrazilIntroduction: The myocutaneous flap is often used in reconstruction of head and neck defects. However, it is restricted to the middle third of the face. Perforating artery dissection techniques allow further lengthening of the pedicle, thus achieving coverage of the orbitofrontal-parietal region. Case report: A 63-year-old male with a poorly-differentiated invasive squamous cell carcinoma presented with a final defect of 12.0 × 18.0 cm in the right orbitofrontal-parietal region, with dura mater, frontal sinus, and right upper orbit exposure after resection. We designed a pectoralis major flap, with a cutaneous island equaling the defect in dimensions, in the right parasternal region, from the fourth intercostal space to the subcostal region (extended). The pedicle was sectioned after 4 weeks. The coverage was effective, with no major complications, and a satisfactory aesthetic result. Conclusion: This flap can be an excellent option for reconstruction of the upper third of the head when there are limitations to microsurgery.http://www.rbcp.org.br/export-pdf/2358/en_v34n1a21.pdfcutaneous neoplasiasquamous cell neoplasiasurgical flapsmyocutaneous flappectoral muscles
spellingShingle Andres Ordenes Evensen
Daniel Cazeto López
Andrés Fernando Cánchica
Carlos Fernando Goyeneche
Leonardo Gobetti
Renato Giannini
Osvaldo Ribeiro Saldanha
Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resection
Revista Brasileira de Cirurgia Plástica
cutaneous neoplasia
squamous cell neoplasia
surgical flaps
myocutaneous flap
pectoral muscles
title Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resection
title_full Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resection
title_fullStr Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resection
title_full_unstemmed Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resection
title_short Extended and pedicled pectoralis major flap for right orbitofrontal-parietal reconstruction following invasive squamous cell carcinoma resection
title_sort extended and pedicled pectoralis major flap for right orbitofrontal parietal reconstruction following invasive squamous cell carcinoma resection
topic cutaneous neoplasia
squamous cell neoplasia
surgical flaps
myocutaneous flap
pectoral muscles
url http://www.rbcp.org.br/export-pdf/2358/en_v34n1a21.pdf
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