Abstract
BACKGROUND: Pectoralis major myocutaneous (PMMC) flap continues to be the workhorse in head and neck reconstruction. Although free tissue transfer has revolutionized the reconstruction in cancers of the oral region, PMMC is still considered a readily accessible source of vascularized soft tissue available to the reconstructive surgeon and especially in most developing nations where due to the cost, time, expertise, or infrastructural constraints free flaps cannot be generally offered. Although commonly used in adults, it has been hardly described for reconstruction in children. CASE PRESENTATION: We present a 4-year-old child with recurrent fibromatosis of the oropharyngeal region where the PMMC was used for reconstruction of the surgical defect and to the best of our knowledge is the youngest patient undergoing reconstruction with PMMC for neoplastic lesion of the head and neck. CONCLUSION: The PMMC flap is justifiably a popular flap that continues to command an important place in the head and neck surgeon's reconstructive armamentarium.