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June 1994

Lymphoscintigraphy in Pectoralis Major Myocutaneous Flaps

Author Affiliations

From the Departments of Otolaryngology–Head and Neck Surgery (Drs Hoşal and Turan) and Nuclear Medicine (Dr Aras), Hacettepe University, Faculty of Medicine, Ankara, Turkey.

Arch Otolaryngol Head Neck Surg. 1994;120(6):659-661. doi:10.1001/archotol.1994.01880300073011

Myocutaneous flaps are used widely in the surgical treatment of advanced cancers, which in the past had been thought to be inoperable. Tumor recurrences are expected more frequently in these patients. Recurrent tumors may spread locally and to the regional areas via lymphatics and vessels. However, the lymphatic spread may differ in cases where myocutaneous flaps are used for reconstruction. This study is based on five patients with head and neck cancer who underwent reconstruction with myocutaneous flaps. Technetium Tc 99m–labeled dextran was used to demonstrate the lymphatic flow, and technetium Tc 99m rhenium sulfur colloid was used to show the lymph nodes of the neck and pectoralis major myocutaneous flap. Our findings show that the newly formed lymphatics do not pierce the fibrotic border of the donor and recipient sides. Lymphatic metastasis may occur to the internal mammary nodes through the myocutaneous flap only after recurrent tumors have invaded the myocutaneous flap directly.

(Arch Otolaryngol Head Neck Surg. 1994;120:659-661)

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