Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery
Background: The pedicled pectoralis major muscle flap (PMMF) is a well established flap for fistula prophylaxis after salvage laryngectomy. To reduce donor site morbidity, we established a modified muscle-sparing harvesting technique. We herein investigate postoperative shoulder function and health-...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-09-01
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| Series: | Healthcare |
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| Online Access: | https://www.mdpi.com/2227-9032/9/9/1158 |
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| author | Tina Rauchenwald Dominik Knierzinger Daniel Dejaco Clemens Hengg Volker H. Schartinger Gerhard Pierer Herbert Riechelmann Dolores Wolfram |
| author_facet | Tina Rauchenwald Dominik Knierzinger Daniel Dejaco Clemens Hengg Volker H. Schartinger Gerhard Pierer Herbert Riechelmann Dolores Wolfram |
| author_sort | Tina Rauchenwald |
| collection | DOAJ |
| description | Background: The pedicled pectoralis major muscle flap (PMMF) is a well established flap for fistula prophylaxis after salvage laryngectomy. To reduce donor site morbidity, we established a modified muscle-sparing harvesting technique. We herein investigate postoperative shoulder function and health-related quality of life (HRQOL). Methods: A chart review of patients receiving the modified muscle-sparing pectoralis major muscle flap between 2013–2020 was performed. Nineteen patients (male = 18, female = 1) were potentially eligible and six male patients were ultimately enrolled. Postoperative shoulder function was assessed on both sides (flap side versus non-flap side) using the Constant Murley Score and the Bak criteria. Health-related quality of life was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire in cancer patients (EORTC QLQ-C30) and head and neck cancer patients (EORTC H&N35). Results: No Constant Murley Score subscale was statistically significant (<i>p</i> ≥ 0.180). Bak criteria was overall rated “Good“. Solely upper extremity adduction force was significantly altered on the flap side (<i>p</i> = 0.039). Median EORTC QLQ-C30 score was 82.2 (IQR 11.1) on the functional scale and 10.3 (IQR 2.6) on the symptomatic scale. Median quality of life score was 75.0 (IQR 33.3) and median EORTC QLQ-H&N35 was 20.6 (IQR 9.8). Conclusions: Postoperative shoulder function after modified muscle-sparing pectoralis major muscle flap surgery is comparable to function of the healthy side with a significant deficiency in adduction force not compromising daily life in this small study cohort. |
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| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-10T07:38:05Z |
| publishDate | 2021-09-01 |
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| series | Healthcare |
| spelling | doaj.art-c59bada7296e48acbdcc1d64e1fc12fc2023-11-22T13:17:48ZengMDPI AGHealthcare2227-90322021-09-0199115810.3390/healthcare9091158Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap SurgeryTina Rauchenwald0Dominik Knierzinger1Daniel Dejaco2Clemens Hengg3Volker H. Schartinger4Gerhard Pierer5Herbert Riechelmann6Dolores Wolfram7Department of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Orthopedics and Traumatology, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Orthopedics and Traumatology, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Otorhinolaryngology, Head and Neck Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaDepartment of Plastic, Reconstructive and Aesthetic Surgery, Medical University of Innsbruck, 6020 Innsbruck, AustriaBackground: The pedicled pectoralis major muscle flap (PMMF) is a well established flap for fistula prophylaxis after salvage laryngectomy. To reduce donor site morbidity, we established a modified muscle-sparing harvesting technique. We herein investigate postoperative shoulder function and health-related quality of life (HRQOL). Methods: A chart review of patients receiving the modified muscle-sparing pectoralis major muscle flap between 2013–2020 was performed. Nineteen patients (male = 18, female = 1) were potentially eligible and six male patients were ultimately enrolled. Postoperative shoulder function was assessed on both sides (flap side versus non-flap side) using the Constant Murley Score and the Bak criteria. Health-related quality of life was assessed with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire in cancer patients (EORTC QLQ-C30) and head and neck cancer patients (EORTC H&N35). Results: No Constant Murley Score subscale was statistically significant (<i>p</i> ≥ 0.180). Bak criteria was overall rated “Good“. Solely upper extremity adduction force was significantly altered on the flap side (<i>p</i> = 0.039). Median EORTC QLQ-C30 score was 82.2 (IQR 11.1) on the functional scale and 10.3 (IQR 2.6) on the symptomatic scale. Median quality of life score was 75.0 (IQR 33.3) and median EORTC QLQ-H&N35 was 20.6 (IQR 9.8). Conclusions: Postoperative shoulder function after modified muscle-sparing pectoralis major muscle flap surgery is comparable to function of the healthy side with a significant deficiency in adduction force not compromising daily life in this small study cohort.https://www.mdpi.com/2227-9032/9/9/1158salvage laryngectomypharyngocutaneous fistulapectoralis major muscle flapshoulder functionquality of lifeConstant Murley Score |
| spellingShingle | Tina Rauchenwald Dominik Knierzinger Daniel Dejaco Clemens Hengg Volker H. Schartinger Gerhard Pierer Herbert Riechelmann Dolores Wolfram Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery Healthcare salvage laryngectomy pharyngocutaneous fistula pectoralis major muscle flap shoulder function quality of life Constant Murley Score |
| title | Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery |
| title_full | Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery |
| title_fullStr | Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery |
| title_full_unstemmed | Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery |
| title_short | Functional Shoulder Outcome and Quality of Life Following Modified Muscle-Sparing Pectoralis Major Flap Surgery |
| title_sort | functional shoulder outcome and quality of life following modified muscle sparing pectoralis major flap surgery |
| topic | salvage laryngectomy pharyngocutaneous fistula pectoralis major muscle flap shoulder function quality of life Constant Murley Score |
| url | https://www.mdpi.com/2227-9032/9/9/1158 |
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