Immediate Head and Neck Reconstruction Trough Pectoral Major Muscle Flap After a Huge Squamous Oncological Resection

The pectoralis major myocutaneous flap (PMMF) has long been considered one of the main flaps for reconstructing defects of substance of the face and neck. PMMF is nowadays increasingly neglected in the face of the rapid growth of free flaps, especially in developed countries. However, it remains of significant use in developing countries. Objective: Report an immediate head and neck reconstruction trough pectoral major muscle flap as a solution after a huge head and neck squamous oncological resection. Clinical Case: 56 years old male with a block oncologic resection that includes cigomatic arch and body + negative intraoperative frozen cut + modified radical neck lymph dissection and, on a second time immediate reconstruction by the Plastic and Reconstructive Surgery service through a left Myocutaneos pectoralis major flap + ipsilateral rotation scalp flap + muscle temporalis left flap and a VY advancement flap. Discusion And Conclusion:Myocutaneous flaps revolutionized the reconstruction of defects in head and neck oncological reconstruction. The pedicled pectoralis major flap is still harvested and mainly indicated for reconstruction in the polymorbid patient. Even with the develop and outcomes of the free flaps and the microsurgery has the gold standard in head and neck reconstruction, the pectoral major myocutaneous flap still maintain as one of the “battlehorse” in reconstructive surgery.