Pectoralis major flap for pharyngocutaneous fistula after total laryngectomy- two different approaches

Introduction. The reconstruction of large postoperative defects after oncologic surgery of head and neck remains challenging. Regional flaps are considered less expensive reconstructive option compared to free flaps. Pectoralis major flap is one of the most versatile choices for reconstruction of large head and neck defects. Case report. We present technical key points for safe harvesting of pectoralis major flap for two cases in a university affiliated tertiary care medical center. Both patients were male, in their seventh decade. Defect sites were: anterior side of neck and lateral neck region. Flaps were used for pharyngocutaneous fistula after total laryngectomy and irradiation. Donor site was closed primary. Both flaps healed primarily without complications. Conclusion. Pectoralis major flap has constant vascular pedicle and can successfully be used for reconstruction of large head and neck defects. Operative technique must be meticulous for obtaining absolute flap survival.