Shoulder morbidity after pectoralis major flap reconstruction for head and neck cancer.

Abstract

BACKGROUND.: The effect of pectoralis major flap (PMF) harvest on shoulder function, allowing for the effects of neck dissection, has not previously been objectively measured. METHODS.: Twenty-two patients who underwent PMF reconstruction were studied. The control group comprised 35 patients with neck dissection (without PMF). Neck dissections in both groups were classified into 3 grades; grade 1: no neck dissection/selective neck dissection; grade 2: modified radical neck dissection; grade 3: radical neck dissection/extended radical neck dissection. Objective shoulder assessments were carried out using Constant score. RESULTS.: Constant score deteriorated with grade of neck dissection (p < .005). The median Constant score for PMF group and neck dissection only group were 82 and 90, respectively (p = .40). Subgroup analysis within neck dissection grade did not show any significant difference, but the effect of PMF was noted to be greatest in grade 2 patients (p = .064). CONCLUSIONS.: There is minimal or low shoulder morbidity, additional to neck dissection, caused by PMF reconstruction in head and neck surgery. (c) 2009 Wiley Periodicals, Inc. Head Neck, 2009.