• J P O'Neill, N Shine, P A Eadie, E Beausang, and C Timon.
• Department of Otolaryngology, Head and Neck Surgery, St James Hospital, Dublin, Ireland. joneill@rcsi.ie
• Ir J Med Sci. 2010 Sep 1; 179 (3): 337343337-43.

BackgroundWith the advent of microsurgery the pedicled flap is considered by many to be an outdated surgical option.AimsTo explore the relationship between flap survival and pre-morbid risk factors, conduct a comparative analysis of flap and systemic morbidities and complete a cosmesis and functionality assessment for oral and oropharyngeal reconstruction patients.Methods114 patients, over a 13-year period, who had a one-stage reconstructive procedure employing the pectoralis major myocutaneous flap (PMMF) or radial forearm-free flap (RFFF).ResultsVariables, including age, smoking and radiation exposure were not statistically significant predictors of flap survival probability. Atelectasis was a significant post-op finding of RFFF patients. Flap dehiscence of >50% was a significant morbidity of PMMF. No statistical difference in cosmetic deformity, diet and socialisation was noted.ConclusionsPectoralis major myocutaneous flap remains an enduring and safe flap; however, the RFFF has markedly improved speech performance over the PMMF.

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