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Pulmonary Function After Pectoralis Major Myocutaneous Flap Harvest
Author(s) -
Talmi Yoav P.,
Benzaray Shlomo,
Peleg Michael,
Eyal Ana,
Bedrin Lev,
Shoshani Yitzhak,
Yahalom Ran,
Horowitz Zeev,
Taicher Shlomo,
Kronenberg Jona,
Shiner Robert J.
Publication year - 2002
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200203000-00012
Subject(s) - medicine , atelectasis , pulmonary function testing , surgery , vital capacity , anesthesia , lung , radiology , lung function , diffusing capacity
Objective The pectoralis major myocutaneous flap is widely used in the reconstruction of surgical defects in the head and neck region. Pulmonary atelectasis has been reported in patients undergoing these procedures, and many of these patients are heavy smokers and drinkers and have associated cardiopulmonary disorders. Flap harvest and donor site closure may lead to impairment of pulmonary function before and after the use of pectoralis major myocutaneous (PMC) in surgical reconstruction in patients with cancer of the head and neck. Methods Patients undergoing extirpation of head and neck tumors with PMC reconstruction were prospectively evaluated. Patient age, smoking history (pack‐years), anesthesia duration, percentage predicted pre‐ and postoperative FEV1, percentage‐predicted pre‐ and postoperative FVC (forced vital capacity), and preoperative SaO 2 (oxygen saturation) were evaluated. Preoperative FEV1/FVC ratio was calculated. Chest x‐rays were reviewed. Results Only 11 patients, 5 of whom smoked, could be evaluated postoperatively. Preoperative FEV1/FVC was more than 70 and FEV1 more than 75% predicted in all patients. A decrease in FVC was observed in 7 of the 11 patients, which ranged between 2% and 27% without any clinically obvious respiratory manifestations. A baseline SaO 2 of more than 96% was noted in all patients. Four of 9 postoperative chest x‐rays demonstrated atelectasis. Conclusions PMC harvest and donor site closure may lead to the recorded decrease in FVC measurements. These changes did not manifest clinically. Nevertheless, alternative methods of surgical defect closure should be considered in patients with severe preexisting pulmonary disorders.