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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Pectoralis major myocutaneous flap /certified fixed orthodontic courses by Indian dental academy
- 1. PECTORALIS MAJOR MYOCUTANEOUS FLAP INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
- 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
- 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
- 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
- 12. INDICATIONS FOR PECTORALIS MAJOR • OROPHARYNX • MANDIBULAR RECONSTRUCTION • ORBITAL EXENTERATION • TEMPORAL BONE RESECTION www.indiandentalacademy.com
- 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
- 24. FLAP ELEVATED Thoracoacromial vessels www.indiandentalacademy.com
- 27. SUTURING THE FLAP TO THE DEFECT www.indiandentalacademy.com
- 30. DONOR SITE CLOSED PRIMARILY www.indiandentalacademy.com
- 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. 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. THANK U www.indiandentalacademy.com Leader in continuing dental education www.indiandentalacademy.com