# Pectoralis major muscle flap reconstruction after a total laryngectomy widened anteriorly: A case report

## TL;DR

This case report shows successful use of a pectoralis major muscle flap for reconstructing a large defect after laryngeal cancer surgery.

## Contribution

Demonstrates the continued effectiveness of pectoralis major flap in complex head and neck reconstructions despite advances in microsurgery.

## Key findings

- Pectoralis major flap achieved excellent post-surgical outcomes in a complex laryngeal cancer case.
- Flap's axial vascularization provides up to 98% viability rate in reconstructive procedures.
- The flap remains a reliable option for cervicofacial reconstruction despite availability of free flaps.

## Abstract

The pectoralis major flap is one of the leading regional pedicled flaps for reconstructive surgery of the head and neck, particularly in oncology after tumor resection. Despite the increasing use of free flaps, this type of flap is still highly recommended in defined indications. It is a highly reliable flap in terms of viability.

We report the case of a man treated in our ENT department for a squamous cell carcinoma of the three laryngeal stages, anteriorly very extensive and requiring total laryngectomy extended to the skin and subcutaneous planes opposite, followed by reconstruction with a flap of the pectoralis major muscle. Post-surgical outcome was excellent.

Aryan was the first person to describe the use of the pectoralis major muscle flap. Since then, several studies have demonstrated the great value of this flap in face and neck reconstruction, thanks to its wide indications and excellent viability rate.

The pectoralis major muscle flap represents a valuable reconstructive option for substance loss in the cervicofacial region despite the great development of microsurgery and free flaps.

•The axial vascularization makes the pectoralis major flap a highly reliable flap, with a viability rate of up to 98%.•This flap's volume is highly advantageous for reconstruction of the neck and lower third of the face after major tumor resection, especially for patients with cancer.•It is a flap with a simple surgical technique based on the preservation of the nourishing pedicle of the pectoralis major muscle.•The pectoralis major muscle flap is still recommended in numerous cases, despite the rise of microsurgery and free flaps.

The axial vascularization makes the pectoralis major flap a highly reliable flap, with a viability rate of up to 98%.

This flap's volume is highly advantageous for reconstruction of the neck and lower third of the face after major tumor resection, especially for patients with cancer.

It is a flap with a simple surgical technique based on the preservation of the nourishing pedicle of the pectoralis major muscle.

The pectoralis major muscle flap is still recommended in numerous cases, despite the rise of microsurgery and free flaps.