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Hadi Seikaly, MD; William M. Kuzon, Jr, MD, MSc; Patrick J. Gullane, MB, ChB, FRCSC; S. J. Herman, MD, FRCP

Arch Otolaryngol Head Neck Surg. 1990;116(5):575-577.

Abstract
• Forty-four patients were reviewed to determine the incidence of atelectasis following pectoralis major myocutaneous flap reconstruction of head and neck defects. Patients underwent tumor resection with subsequent pectoralis major myocutaneous flap reconstruction (flap group, n = 24) or another major head and neck procedure (control group, n = 20). Chest roentgenograms taken on the first postoperative day were scored for atelectasis by preestablished criteria. Sixty-five percent of control and 70% of flap patients demonstrated postoperative atelectasis roentgenographically. The flap patients with skin paddles larger than 40 cm² had a 60% incidence of major atelectasis compared with 5% in control patients. The skin island area was strongly correlated with the atelectasis score in the flap group. These results suggest that atelectasis is common following pectoralis major myocutaneous flap reconstruction of head and neck defects. As well, decreased chest wall compliance after primary closure of large donor defects may contribute to the atelectasis observed.

(Arch Otolaryngol Head Neck Surg. 1990;116:575-577)

Author Affiliations
From the Departments of Otolaryngology (Drs Seikaly and Gullane), Surgery (Dr Kuzon), and Radiology (Dr Herman), University of Toronto (Canada).

Footnotes
Accepted for publication January 3, 1990.

Reprint requests to EN7-242, The Toronto Hospital, Toronto General Site, 200 Elizabeth St, Toronto, Ontario, Canada M5G 2C4 (Dr Gullane).

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