Pectoralis Major Flap

The pectoralis major flap, originally described by Ariyan in 1979, is a versatile and commonly employed reconstructive option in head and neck surgery. Its utility has changed in recent years with the widespread adoption of free flaps for head and neck reconstruction such that it now primarily serves a supplementary role in patients who are poor free flap candidates or if a salvage intervention is required. The flap can be harvested in a myocutaneous or myofascial plane, providing a reliable reconstruction option for mucosal, pharyngeal, and cutaneous defects of the head and neck region that are at or below the level of the zygomatic arch.