The pectoralis major myocutaneous (PMMC) flap has been used as a versatile and reliable flap since its first description by Ariyan in 1979, utilizing single arterial supply from thoracoacromial artery. AIM: - This study is designed to evaluate the outcome of the preservation versus sacrificing the lateral thoracic artery in pmmc flap while salvaging the head and neck defects. METHOD: - Study was conducted on patients who reported and were undergoing treatment for malignant lesions within the oral cavity at the department of Oral and Maxillofacial surgery in Rama dental college, Hospital and Research Centre, Kanpur. RESULTS: - In a study of total of 50 patients divided randomly in 2 groups with 25 in each group, 38 were males (76%) and 12 were female (24%) patients. Group 1 comprised of 20 male and 5 female patients and 18 male patients and 7 female patients were in group 2. Eventually we noted that in both the groups where the length of the flap was variable, either preserving or sacrificing the LTA, we couldn’t find any distal skin necrosis in the flap in majority of cases. CONCLUSSION: - An overall conclusion drawn from this study is that both groups had more or less similar results, except of a particular case from the preservation group where despite preserving the artery in a female patient there was a flap failure, it is fair to state that in some cases, mostly females’ patients due to presence excessive fibro fatty tissues arterial compression may lead to flap failure.

Keywords : PMMC, Thoracoacromial, Tumour, CMS, Xiphoacromial.