Oral cavity cancers account for 30% of head and neck cancers and represent a significant challenge to clinicians. Treatment requires multi disciplinary expertise and is complicated by. the complex role that the oral cavity plays in speech, mastication, and swallowing. Surgery remains the cornerstone of most treatment regimens; the primary objective is cure, not withstanding preservation of form and function to retain a good quality of life that can be further improved by reconstructive techniques using various local flaps, distant flaps or microvascular reconstruction. The pectoralis major [PM] flap has many advantages in that it is very reliable, and allows a single-stage reconstruction of most head and neckdefects to the level of the maxilla with well-vascularized tissue capable of carrying a large skin paddle. The donor site morbidity is surprisingly low, and few patients complain of difficulties with arm movement.

This paper revisits the surgical anatomy and technique of harvesting the Pectoralis Major myocutaneous flap used to reconstruct complex defects of the lower face following composite therapeutic resection. In addition, we describe our experience using this flap and discuss associated merits and demerits and complications.

Despite contemporary micro vascular techniques, the Pectoralis Major myocutaneous flap continues to be a versatile option in the reconstruction of complex head and neck defects following ablative surgery. However, regardless of the site, stage and degree of tumor differentiation, such cases will always pose as a therapeutic challenge to the reconstructive surgeon.