The subclavicular versus the supraclavicular route for pectoralis major myocutaneous flap: a cadaveric anatomic study

• Published in: European archives of oto-rhino-laryngology 2010-07, Vol.267 (7), p.1141-1146
• Main Authors: Vanni, Christiana Maria Ribeiro Salles, Pinto, Fábio Roberto, de Matos, Leandro Luongo, de Matos, Maria Graciela Luongo, Kanda, Jossi Ledo
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Cadaver; Clavicle; Head - surgery; Head and Neck; Head and Neck Surgery; Humans; Male; Medical sciences; Medicine; Medicine & Public Health; Neck - surgery; Neurosurgery; Otorhinolaryngology; Otorhinolaryngology. Stomatology; Pectoralis Muscles - transplantation; Reconstructive Surgical Procedures - methods; Surgical Flaps
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-010-1203-5

The aim of this paper was to determine if the subclavicular route of rotation improved the pectoralis major myocutaneous flap’s ability to reach head and neck sites in comparison to the traditional supraclavicular rotation. We dissected 50 flaps in 25 fresh adult male cadavers. The length of the pedicle and the flap’s ability to reach five anatomical head and neck sites (laryngeal prominence of thyroid cartilage, mentum, angle of the mandible, external auditory canal, and orbit) were tested by supraclavicular and subclavicular rotation. Although the average length of the flap’s pedicle was higher when the subclavicular rotation was employed, there was no statistical difference between the two techniques concerning the flap’s ability to reach the studied sites. Our results suggest that the subclavicular route apparently adds little to the reconstruction of head and neck defects using the pectoralis major myocutaneous flap. We believe that the indication of this technique should be evaluated on a case-by-case basis before it is recommended to keep from unnecessarily increasing the potential morbidity of the reparative procedure.