Anatomical and preclinical study of repair of cervical tracheal wall defects with vascularized pectoralis major tendon flaps / 中华显微外科杂志

ABSTRACT

Objective To provide an anatomical basis for repairing the defect of cervical tracheal wall with vascularized pectoralis major tendon flaps.Methods Thirty-two lateral thoracic necrotomies were studied for the following aspects.Measurement of pectoralis major tendons' length,width and thickness.Anatomy of thoracoacromialartery,pectoral branchesorigin,distribution.Measurement of length of pedicle,rotated radius of flaps and length from recipient site.An imitative operation was undergone on a specimen of corpse.One patient was undergone the operation of repairing the 3.0 cm × 1.5 cm defect of anterior cervical trachea wall,accompanying with incision infection,with pectoralis major tendon flap.Results Length of pectoralis major tendon(22.9 ± 0.9)mm.Width of tendon(51.0± 2.4)mm.Thickness of tendon(5.81± 1.35)mm.Length of pedicle(89.3 ± 5.3) mm.The radius of pedicle pectoralis major myotendinous flap(121.7± 8.2)mm.The distance from pivot point of flap to central point of recipient(96.5 ± 8.9)mm.Patient possessed normal pronunciation,good appearance and no emphysema at 5 months' follow-up.Tracheal lumen,measured 2.6 cm in the anteroposterior dimension and 1.8 cm in the lateral dimension,showed no recurrence of obvious stenosis in cervical computed tomography at 3 month postoperatively.Conclusion Pedicle pectoralis major tendon flaps,originated from thoracoacromial artery pectoral branches can repair cervical tracheal wall defects effectively.