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May 1984

Latissimus Dorsi Myocutaneous Flap

Author Affiliations

Van Nuys, Calif

Arch Otolaryngol. 1984;110(5):341. doi:10.1001/archotol.1984.00800310065016

To the Editor.—In his July 1982 Archives article, Schuller1 described a 74-year-old man with a recurrent solitary plasmacytoma of the maxillary antrum as an exemplary use of the latissimus dorsi myocutaneous flap. Nowhere in the case history did Schuller mention the use of radiation therapy for this patient. If this man was not given the choice, which would have saved his eye, face, and self-esteem and most probably would have cured his local disease, a disservice has been done. It is well known that properly delivered megavoltage radiation beams can permanently control solitary plasmacytomas with doses in the range of 3,500 to 5,000 rad in three to six weeks.2-5

These doses will not ordinarily interfere with lacrimation, but will result in excellent cosmesis and minimal changes in his skin and oral mucosa. Even the initial maxillectomy could be questioned, since this tumor is radiosensitive and could have

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