Il lembo muscolo-cutaneo selettivo di grande pettorale

The use of pectoralis major myocutaneous flaps is widespread in the reconstruction of the head and neck but it results in poor cosmetic and functional outcome for the donor area, especially when dissection of the cervical nodes damages the nerves of the ipsilateral m. Trapezius. The Pectoralis Major can be divided into three main segments, i.e., clavicular, external and sternocostal, all of which have independent blood and nerve supplies and function. Each of those can be trasposed individually. Section of the nervous branches supplying the transposed muscular segment should therefore preserve function of the remaining muscle. To assess feasibility and outcome of such surgical procedure we have compared results in two groups of 10 patients each, all operated in our Department. All cases had undergone reconstruction following tumors of the head and neck with respectively 'traditional' and segmental transposition of a myocutaneous flap of Pectoralis Major. Electromyography and cosmetic results confirm the positive outcome of segmental transposition, although no statistically significant difference has been noted in terms of residual muscular function of the ipsilateral sternocostal and external segments between the two groups of patient.