Anterior mediastinal tracheostomy with a pectoralis major musculocutaneous flap.

We suggest the pectoralis major musculocutaneous flap is a simple and reliable technique in constructing a mediastinal tracheostomy. It has the advantage of excellent vascularity and reliability even in those patients who have undergone preoperative radiation therapy. In addition, a well-vascularized lobe of thyroid tissue placed over the pharyngogastric anastomosis may decrease anastomotic leaks.