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<p>Reconstruction of pharyngeal and neck skin defects following total or salvage laryngectomy is challenging, particularly in resource-limited settings. While free flaps are preferred, pedicled flaps such as the Pectoralis Major Myocutaneous (PMMC) and Deltopectoral (DP) flaps remain valuable alternatives in medically unfit patients. This retrospective case series analyzed 8 patients who underwent combined PMMC and DP flap reconstruction between January 2024 and December 2024. Three patients had primary laryngeal carcinoma with skin involvement, and five were salvage cases with pharyngeal dehiscence or neck skin necrosis. Two patients (25%) developed pharyngocutaneous fistula; one required contralateral PMMC reconstruction, while the other was managed conservatively. One patient developed partial DP flap necrosis requiring revision, and another had wound infection managed with antibiotics. Swallowing rehabilitation and radiotherapy tolerance were satisfactory. The combined PMMC and DP flap is a reliable, versatile, and practical reconstructive option, especially in settings lacking microvascular facilities.</p>

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Combined Pectoralis Major Myocutaneous Flap (PMMC) and Deltopectoral Flap (DP) for Pharyngeal and Neck Defect After Total Laryngectomy: A Case Series from Tertiary Care Centre

  • 期刊论文

  • 发表日期：

    2026年3月23日

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  • Vinod Kumar Sharma,
  • Deepak Singh Panwar,
  • Suresh Singh,
  • Kamal Kishor Lakhera,
  • Pinakin Patel,
  • Yashasvi Patel,
  • Rajat Chaudhary

摘要

Reconstruction of pharyngeal and neck skin defects following total or salvage laryngectomy is challenging, particularly in resource-limited settings. While free flaps are preferred, pedicled flaps such as the Pectoralis Major Myocutaneous (PMMC) and Deltopectoral (DP) flaps remain valuable alternatives in medically unfit patients. This retrospective case series analyzed 8 patients who underwent combined PMMC and DP flap reconstruction between January 2024 and December 2024. Three patients had primary laryngeal carcinoma with skin involvement, and five were salvage cases with pharyngeal dehiscence or neck skin necrosis. Two patients (25%) developed pharyngocutaneous fistula; one required contralateral PMMC reconstruction, while the other was managed conservatively. One patient developed partial DP flap necrosis requiring revision, and another had wound infection managed with antibiotics. Swallowing rehabilitation and radiotherapy tolerance were satisfactory. The combined PMMC and DP flap is a reliable, versatile, and practical reconstructive option, especially in settings lacking microvascular facilities.