Pulmonary function after pectoralis major myocutaneous flap harvest

Yoav P. Talmi, Shlomo Benzaray, Michael Peleg, Ana Eyal, Lev Bedrin, Yitzhak Shoshani, Ran Yahalom, Zeev Horowitz, Shlomo Taicher, Jona Kronenberg, Robert J. Shiner

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

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 SaO2, (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 SaO2 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.

Original languageEnglish
Pages (from-to)467-471
Number of pages5
JournalLaryngoscope
Volume112
Issue number3
StatePublished - Mar 26 2002
Externally publishedYes

Fingerprint

Myocutaneous Flap
Lung
Vital Capacity
Pulmonary Atelectasis
Neck
Thorax
Head
X-Rays
Tissue Donors
Preexisting Condition Coverage
Head and Neck Neoplasms
Anesthesia
Smoking
History
Oxygen

Keywords

  • Head and neck cancer
  • Health status
  • Myocutaneous flap
  • Outcome measures
  • Pulmonary function

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Talmi, Y. P., Benzaray, S., Peleg, M., Eyal, A., Bedrin, L., Shoshani, Y., ... Shiner, R. J. (2002). Pulmonary function after pectoralis major myocutaneous flap harvest. Laryngoscope, 112(3), 467-471.

Pulmonary function after pectoralis major myocutaneous flap harvest. / Talmi, Yoav P.; Benzaray, Shlomo; Peleg, Michael; Eyal, Ana; Bedrin, Lev; Shoshani, Yitzhak; Yahalom, Ran; Horowitz, Zeev; Taicher, Shlomo; Kronenberg, Jona; Shiner, Robert J.

In: Laryngoscope, Vol. 112, No. 3, 26.03.2002, p. 467-471.

Research output: Contribution to journalArticle

Talmi, YP, Benzaray, S, Peleg, M, Eyal, A, Bedrin, L, Shoshani, Y, Yahalom, R, Horowitz, Z, Taicher, S, Kronenberg, J & Shiner, RJ 2002, 'Pulmonary function after pectoralis major myocutaneous flap harvest', Laryngoscope, vol. 112, no. 3, pp. 467-471.
Talmi YP, Benzaray S, Peleg M, Eyal A, Bedrin L, Shoshani Y et al. Pulmonary function after pectoralis major myocutaneous flap harvest. Laryngoscope. 2002 Mar 26;112(3):467-471.
Talmi, Yoav P. ; Benzaray, Shlomo ; Peleg, Michael ; Eyal, Ana ; Bedrin, Lev ; Shoshani, Yitzhak ; Yahalom, Ran ; Horowitz, Zeev ; Taicher, Shlomo ; Kronenberg, Jona ; Shiner, Robert J. / Pulmonary function after pectoralis major myocutaneous flap harvest. In: Laryngoscope. 2002 ; Vol. 112, No. 3. pp. 467-471.
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AU - Talmi, Yoav P.

AU - Benzaray, Shlomo

AU - Peleg, Michael

AU - Eyal, Ana

AU - Bedrin, Lev

AU - Shoshani, Yitzhak

AU - Yahalom, Ran

AU - Horowitz, Zeev

AU - Taicher, Shlomo

AU - Kronenberg, Jona

AU - Shiner, Robert J.

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N2 - 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 SaO2, (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 SaO2 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.

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