PECTORALIS MAJOR MYOCUTANEOUS FLAP

INDIAN DENTAL ACADEMY
Leader in continuing dental education
www.indiandentalacademy.co...
INTRODUCTION
• Development of myocutaneous flap- mid 70’s.
• Floor of the mouth, lateral tongue- sternocleidomastoid,
temp...
TEMPORALIS MUSCLE FLAP

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TEMPORALIS MUSCLE
NASOLABIAL FLAP

NASOLABIAL
FLAP

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PECTORALIS
MAJOR

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ANATOMY
BLOOD SUPPLY
 Thoracoacromial artery, Lateral thoracic, Superior thoracic artery,
and Intercostal perforators fro...
THORACOACROMIAL
ARTERY
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• ORIGN:- 1) Clavicular head
2)Sternocostal head
• INSERTION:- Lateral lip of intertubercular groove of
humerus
• ACTION:-...
Clavicular head

Sternoclavicular head
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SURFACE MARKING

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INDICATIONS FOR PECTORALIS MAJOR
• OROPHARYNX
• MANDIBULAR RECONSTRUCTION
• ORBITAL EXENTERATION
• TEMPORAL BONE RESECTION...
CASES
1

2

3

4

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5

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CASE DETAILS
• CASE 1:- tumor-Lt gingivo buccal complex
nodal involvement-node positive
preop radiation-yes
 CASE 2:- tum...
DISSECTION MARKING

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AFTER RESECTION

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DISSECTED SPECIMENS

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DEFECT

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INCISION MARKING

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DISSECTION

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PECTORALIS MAJOR MUSCLE

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PEDICLE MARKING

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FLAP ELEVATED

Thoracoacromial vessels www.indiandentalacademy.com
INSET OF FLAP

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TUNNELING SUPRACLAVICULARLY

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SUTURING THE FLAP TO THE DEFECT

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FLAPS IN POSITION

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DONOR SITE

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DONOR SITE CLOSED PRIMARILY

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HEALING

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CASE 5

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ADVANTAGES
•
•
•
•
•
•
•

Single stage repair
Single dominant blood supply
Provides inner and outer lining
Protects caroti...
DISADVANTAGES
•
•
•
•
•

Might be too bulky for oral cavity
Arc of rotation limited for upper facial defects
Shoulder func...
THANK U
www.indiandentalacademy.com
Leader in continuing dental education

www.indiandentalacademy.com
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Pectoralis major myocutaneous flap /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy provides dental crown & Bridge,rotary endodontics,fixed orthodontics,
Dental implants courses.for details pls visit www.indiandentalacademy.com ,or call
00919248678078

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Transcript of "Pectoralis major myocutaneous flap /certified fixed orthodontic courses by Indian dental academy "

  1. 1. PECTORALIS MAJOR MYOCUTANEOUS FLAP INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. INTRODUCTION • Development of myocutaneous flap- mid 70’s. • Floor of the mouth, lateral tongue- sternocleidomastoid, temporalis, nasolabial flaps. • Larger defects- free flaps, regional flaps. www.indiandentalacademy.com
  3. 3. TEMPORALIS MUSCLE FLAP www.indiandentalacademy.com TEMPORALIS MUSCLE
  4. 4. NASOLABIAL FLAP NASOLABIAL FLAP www.indiandentalacademy.com
  5. 5. PECTORALIS MAJOR www.indiandentalacademy.com
  6. 6. ANATOMY BLOOD SUPPLY  Thoracoacromial artery, Lateral thoracic, Superior thoracic artery, and Intercostal perforators from internal mammary artery NERVE SUPPLY  Lateral and medial pectoral nerves www.indiandentalacademy.com
  7. 7. THORACOACROMIAL ARTERY www.indiandentalacademy.com
  8. 8. www.indiandentalacademy.com
  9. 9. • ORIGN:- 1) Clavicular head 2)Sternocostal head • INSERTION:- Lateral lip of intertubercular groove of humerus • ACTION:-Adducts and medially rotates humerus; draws scapula anteriorly and inferiorly Acting alone: clavicular head flexes humerus and sternocostal head extends it. www.indiandentalacademy.com
  10. 10. Clavicular head Sternoclavicular head www.indiandentalacademy.com
  11. 11. SURFACE MARKING www.indiandentalacademy.com
  12. 12. INDICATIONS FOR PECTORALIS MAJOR • OROPHARYNX • MANDIBULAR RECONSTRUCTION • ORBITAL EXENTERATION • TEMPORAL BONE RESECTION www.indiandentalacademy.com
  13. 13. CASES 1 2 3 4 www.indiandentalacademy.com
  14. 14. 5 www.indiandentalacademy.com
  15. 15. CASE DETAILS • CASE 1:- tumor-Lt gingivo buccal complex nodal involvement-node positive preop radiation-yes  CASE 2:- tumor -right gingivo buccal complex nodal involvement-node positive preop radiation-no  CASE 3:- tumor- left gingivo buccal complex nodal involvement-node positive preop radiation-no • CASE 4:- tumor size- Lt gingivo buccal complex nodal involvement- node positive preop radiation-no www.indiandentalacademy.com
  16. 16. DISSECTION MARKING www.indiandentalacademy.com
  17. 17. AFTER RESECTION www.indiandentalacademy.com
  18. 18. DISSECTED SPECIMENS www.indiandentalacademy.com
  19. 19. DEFECT www.indiandentalacademy.com
  20. 20. INCISION MARKING www.indiandentalacademy.com
  21. 21. DISSECTION www.indiandentalacademy.com
  22. 22. PECTORALIS MAJOR MUSCLE www.indiandentalacademy.com
  23. 23. PEDICLE MARKING www.indiandentalacademy.com
  24. 24. FLAP ELEVATED Thoracoacromial vessels www.indiandentalacademy.com
  25. 25. INSET OF FLAP www.indiandentalacademy.com
  26. 26. TUNNELING SUPRACLAVICULARLY www.indiandentalacademy.com
  27. 27. SUTURING THE FLAP TO THE DEFECT www.indiandentalacademy.com
  28. 28. FLAPS IN POSITION www.indiandentalacademy.com
  29. 29. DONOR SITE www.indiandentalacademy.com
  30. 30. DONOR SITE CLOSED PRIMARILY www.indiandentalacademy.com
  31. 31. HEALING www.indiandentalacademy.com
  32. 32. CASE 5 www.indiandentalacademy.com
  33. 33. www.indiandentalacademy.com
  34. 34. www.indiandentalacademy.com
  35. 35. www.indiandentalacademy.com
  36. 36. www.indiandentalacademy.com
  37. 37. www.indiandentalacademy.com
  38. 38. www.indiandentalacademy.com
  39. 39. www.indiandentalacademy.com
  40. 40. www.indiandentalacademy.com
  41. 41. www.indiandentalacademy.com
  42. 42. ADVANTAGES • • • • • • • Single stage repair Single dominant blood supply Provides inner and outer lining Protects carotid artery Sufficient skin and soft tissue bulk Good arc of rotation Donor site closed primarily www.indiandentalacademy.com
  43. 43. DISADVANTAGES • • • • • Might be too bulky for oral cavity Arc of rotation limited for upper facial defects Shoulder function impaired Distal skin blood supply not reliable Distortion of symmetry in donor site SUPRACLAVICULAR BULGE DISTORTED BREAST www.indiandentalacademy.com
  44. 44. THANK U www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com

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