[Cavernous capsulated hemangioma of the pectoral muscle].
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Hemangioma↗
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Results for “PECTORALIS MUSCLES”
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[Alar scapula due to paralysis of the serratus anterior muscle and of the lower fascia of the trapezius, cured by transplantation of the lower third of the pectoralis major on the inferior angle of the scapula].
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Fascia↗
Congenital absence of pectoral muscles.
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Adult↗
[Traumatic rupture of the pectoral major muscle].
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Adult↗
Surgical treatment of complications 45 years after extraperiosteal pneumonolysis and plombage using acrylic resin balls for cavitary pulmonary tuberculosis.
An infected axillary sinus tract discharged balls made of an acrylic resin consisting essentially of polymerized methyl methacrylate (Lucite) 45 years following performance of an extraperiosteal pneumonolysis and Lucite ball plombage for collapse therapy of right upper lobe cavitary tuberculosis. Surgical extraction of the balls was performed, followed by a partial decortication of the lung and intrathoracic transposition of a pectoralis major muscle flap to fill the residual pleural space. Primary healing was attained, and the patient is well 1 1/2 years after surgery.
Axilla↗
[A rare case of breast ectopy associated with partial agenesis of osteo-muscular structures of the thoracic wall. Proposal of an original reparative technique].
The Authors report a case of chest wall malformation characterized by costal defect (6th and 7th ribs), hypoplasia of the serratus and pectoralis major muscles, left mammary ectopy and mucoviscidosis. The case is reported because of the very singular malformative association and the originality of the reparative procedure. Appearance has been improved and a good shape and breast projection achieved.
Adolescent↗
Poland-Möbius syndrome associated with dextrocardia.
A newborn male with Möbius syndrome, Poland anomaly, and dextrocardia is described. This is the second case reported of Poland-Möbius syndrome associated with dextrocardia. The patient presented with strabismus, facial diplegia, difficulty in swallowing, hypoplasia of the left pectoralis major muscle, partial absence of the upper costal cartilages, absence of the left areola, hypoplasia of the left forearm and hand, and dextrocardia without murmurs.
Abnormalities, Multiple↗
Delayed failure of myocutaneous flaps in head and neck reconstruction.
Since the concept of myocutaneous flap reconstruction of the head and neck region was introduced it has opened a new approach to surgical management in this area. This flap not only reduced the number of operations as compared to "staged procedure", but also reduced the costs of medical care. We are, however, experiencing significant failures as the applications of this flap are extended. This paper reviews our experience with myocutaneous flaps in 15 partial and total failures. An evaluation of these failures reveals that most occurred 1 1/2 to 3 weeks after reconstruction. The factors predisposing to failure seem related more to technical errors rather than to general factors. Diabetes, peripheral vascular disease, malnutrition and low hemoglobin, and low blood pressure were not major contributors to the failures in our series. Local factors predisposing to failure of myocutaneous flaps can be divided into two large categories--arterial failure and venous failure. In our series of unsuccessful myocutaneous flaps, the major factors appeared to be venous stasis leading to arterial insufficiency. All failures had developed after the initial critical period of flap survival (7-10 days). The following techniques showed an especially high rate of failure: 1. SCM--myocutaneous flap to resurface floor of mouth. 2. Tubed pectoralis myocutaneous flap to reconstruct pharynx and esophagus. 3. Flaps developed with very narrow vascular pedicles. Individual cases representing delayed failure are presented.
Esophageal Neoplasms↗
Soft tissue coverage of mandibular reconstruction plates.
Free tissue transfer was compared to pectoralis major flap coverage of mandibular reconstruction plates in a retrospective review. The study group consisted of 14 patients whose composite defects were reconstructed with metal plates covered with either pectoralis flaps (9) or soft tissue free flaps (5). Four patients in the pectoralis group (44%) had plates that extruded compared to none in the free flap group. The mean operating room time for the free flap group (721 minutes) was longer than the pectoralis group (550 minutes), but the overall hospital stay for the free flap group (20 days) was half that of the pectoralis group (39 days). The pectoralis group required more secondary procedures (88%) than the free flap group (20%). Free flaps have a higher success rate, a shorter hospital stay, and require fewer additional procedures than do pectoralis flaps. This justifies the longer operating time and greater technical complexity of free tissue transfer for reliable coverage of mandibular reconstruction plates.
Aged↗
Chondroradionecrosis of larynx following radiotherapy for metastatic neck disease originating from oral carcinoma.
Chondroradionecrosis of larynx is a rare but serious complication of radiotherapy. Here is described a case of chondroradionecrosis after 20 years of completion of radiotherapy for oral cancer. The patient underwent excision of necrotic anterior skin of the neck, together with devitalized thyroid cartilage and most of the cricoid cartilage, and reconstruction with pectoralis major muscle transposition. This resulted in preservation of laryngeal function, and avoided further exploration of the irradiated neck and possible further skin loss.
Adult↗
Analysis of myosin isoform transitions during growth and development in diverse chicken genotypes.
The temporal expression of chicken skeletal fast myosin heavy chain (MyHC) isoforms in pectoralis major muscle was characterized in 3 commercial broiler lines at embryonic d 19 and at 7, 14, and 21 d posthatch. Lines A and B have been selected for breast yield, and line C is a fast' growing commercial line with limited selection for carcass traits. The isoform transitions in breast muscle samples were compared with samples from Single Comb White Leghorns (line D) using a semiquantitative immunoassay. The hypothesis was that selection for growth and carcass development in broilers would be accompanied by changes in the temporal expression of one or more of the chicken fast MyHC isoforms. Embryos from all lines were sampled at 19 d of incubation, and chicks were randomly sampled at 7, 14, and 21 d post-hatch. Myosin was extracted from pectoralis major muscle and assayed for purity and total protein concentration by SDS-PAGE and bincinchoninic acid protein analyses, respectively. The relative concentration of MyHC isoforms was evaluated by semiquantitative ELISA with 3 monoclonal antibodies specific for chicken skeletal fast embryonic and adult (eMyHC, aMyHC; EB165), neonatal (nMyHC; 2E9), and adult (aMyHC; AB8) myosin, respectively. The overall temporal expression of the myosin isoforms, eMyHC, nMyHC, and aMyHC, was similar in all lines. With eMyHC, at 19 d of incubation, line B had lower expression than lines A, C, and D. Expression of nMyHC, in lines C and D was similar with expression being highest at 7 d and lower at 14 d and 21 d. In lines A and B, however, nMyHC expression was higher at hatch than lines C and D. In line D, aMyHC was expressed at 14 d and increased through 21 d, whereas in lines A, B, and C, aMyHC isoform was expressed and was higher at 7 d and increased through 21 d. The results of this experiment support our hypothesis that commercial broilers have different temporal expression patterns of the developmental chicken fast MyHC isoforms.
Aging↗
Poland anomaly in mother and daughter.
We report on Poland anomaly in a mother and her daughter. Further family history was negative for abnormalities of the hands or the pectoralis major muscle. A review of published cases of familial Poland anomaly is presented. Implications concerning the possible etiology of familial cases of Poland anomaly are given.
Adult↗
Versatility of botulinum toxin: a use in stabilization of pedicled muscle flaps.
BACKGROUND: In this study, botulinum toxin A was used to secure the stabilization of muscle flaps without denervation atrophy. METHODS: Thirty adult female Wistar rats were divided into a control group (group I, n = 10), a denervation group (group II, n = 10), and a botulinum toxin A group (group III, n = 10). In all of the groups, pedicled pectoralis major muscle flaps were elevated from the sternal attachment on the right side. In the second group, muscle flaps were denervated by transsecting the pectoralis major nerve after flap elevation; in the third group, botulinum toxin A (1.4 U of Dysport; Ipsen, Maidenhead, United Kingdom) was injected into the prepared muscle flap before flap replacement. The distance between the medial side of the muscle and the midline was measured at 4 weeks. Histopathological examination was performed 10 weeks after the first operation. The diameter of the muscle fibers was measured, and the degree of atrophy in the muscle flaps was evaluated in all groups. RESULTS: Mean distances from the midline were statistically significantly different in all of the groups (p = 0.000, p < 0.01). There was a significant difference in muscle fiber diameter among the groups (p = 0.000, p < 0.01). Temporary denervation by botulinum toxin A and irreversible denervation with transsection of the motor nerve caused the reduced diameters of the muscle fibers. In addition, moderate to severe muscle atrophy in group II and mild to moderate muscle atrophy in group III were observed. CONCLUSIONS: In the pedicled muscle flaps, botulinum toxin A can be used easily and reliably for stabilization. It was concluded that detachment of the muscle flap might be prevented and operative morbidity decreased using this method.
Animals↗
Male chest correction. Pectoral implants and gynecomastia.
Implants have been developed in different sizes and shapes to mimic the pectoralis major muscle and its nipple-areolar complex below it. These soft, solid silicone implants have the approximate dimensions in height, length, and thickness as the muscle the implant is to mimic. Some improvements in the treatment of breast hypertrophy have also allowed a better result in the surgery of gynecomastia. The challenge of obtaining a smooth and flat result has been helped by the technique of liposuction with circum-areolar excision.
Esthetics↗
Langer's axillary arch: anatomy, embryological features and surgical implications.
Langer's arch is identified in up to 7% of axillary explorations; in a three-month period we identified three individuals among forty-six patients undergoing axillary surgery with this abnormality. Langer's arch is a muscular-tendinous structure that usually extends from latissimus dorsi to pectoralis major muscle. The purpose of this article is to describe the embryological derivation of this muscular variant from the panniculus carnosus and to define its anatomical features. The clinical implications both symptomatically and as an unexpected finding during axillary dissection, are also discussed.
Axilla↗
Vascularized muscle flaps and reoperative approach for complicated, dehisced sternal wounds in children.
Vascularized muscle flaps for treatment of mediastinitis and sternal wound dehiscence have become standard treatment practice, but triple-muscle flap reconstruction is reserved for the more complex wounds. The incisional approach for reoperation in such patients is controversial. We report an extremely ill infant, born at 38 weeks gestational age, who underwent an arterial switch procedure for transposition of the great arteries at 12 days of age. Sternal wound infection, dehiscence, mediastinitis, and extensive wound necrosis complicated the postoperative course. The cultured organism Enterobacter is a relatively rare cause for median sternotomy wound infection and was associated with massive postoperative hemorrhage. The infant underwent multiple debridements and at 2 months of age had reconstructive surgery with bilateral pectoralis major muscle advancement flaps combined with a rectus abdominis muscle flap. Three months postreconstruction the infant required reoperation to correct a stenosis at the site of the pulmonary artery anastomosis. This surgery was carried out through the previous median sternotomy scar because it was the safest, most direct approach and would also limit additional scarring. Long-term follow-up at 2 years of age shows a well-developed young boy with no limitations in growth and activity.
Anti-Bacterial Agents↗
Pharyngocutaneous fistulas in advanced cancer: closure with musculocutaneous or muscle flaps.
Two hundred cases of head and neck cancer were reviewed and 16 pharyngocutaneous fistulas identified, for an incidence of 6 percent. The fistulas were closed with pectoralis major muscle flaps in four patients, pectoralis musculocutaneous flaps in seven patients, sternocleidomastoid muscle flaps in four patients, and latissimus dorsi flaps in two patients. Four types of fistulas were identified, and flap selection was determined by fistula location. Successful closure was obtained in 15 patients (88 percent), although one patient died from recurrence with a persistent fistula.
Combined Modality Therapy↗
Pectoralis major transfer for anterior-superior subluxation in massive rotator cuff insufficiency.
The purpose of this study was to evaluate the outcome after subcoracoid pectoralis major transfer for anterior-superior shoulder instability in massive rotator cuff insufficiency. Fourteen patients underwent subcoracoid pectoralis major transfer for this debilitating surgical complication. At a mean 17.5-month follow-up, there were 11 satisfactory and 3 unsatisfactory results. Nine of the patients were satisfied with the procedure and would repeat the operation under similar circumstances. Pain scores, as measured on a visual analog scale, decreased from 6.9 to 3.2 postoperatively. Mean forward flexion increased from 24.4 degrees to 60.8 degrees. American Shoulder and Elbow Society functional outcome score increased from 27.2 preoperatively to 47.7 postoperatively. Thirteen of the fourteen patients had improved humeral head containment and improved ability to perform activities of daily living at waist level. A subcoracoid pectoralis major muscle transfer has a low complication rate and is a viable option in this difficult patient population, with better results than those previously reported.
Activities of Daily Living↗