Immediate reconstruction of the pharynx and cervical esophagus with the pectoralis major myocutaneous flap following laryngopharyngectomy.

The "island" pectoralis major myocutaneous flap has been used in nine patients for immediate hypopharyngeal and cervicoesophageal reconstruction following laryngopharyngectomy. Two patients underwent total hypopharyngeal and cervicoesophageal reconstruction. Postoperative evaluation revealed adequate lumens with no evidence of stricture. There was retained innervation of the flaps through the lateral pectoral nerve, but no additional innervation from the cricopharyngeal musculature could be demonstrated. Normal esophageal motility was maintained, but cervicoesophageal pressures were diminished. Donor site morbidity was minimal, and the complication rate was low. We present the pectoralis major myocutaneous flap as an alternate method for hypopharyngeal and cervicoesophageal reconstruction.