Immediate pharyngoesophageal reconstruction. Use of a quilted skin-grafted pectoralis major muscle flap.

Pharyngoesophageal reconstruction continues to be a problem in the management of cancer involving the hypopharynx. In our experience, the use of deltopectoral and pectoralis major myocutaneous flaps for total reconstruction has been disappointing. We report four cases of immediate near-total reconstruction using a quilted , skin-grafted pectoralis major muscle flap. All cases had received full dosage preoperative irradiation. A thin-walled pharynx was created that has allowed early development of a good esophageal voice. There has been no stricture formation. All patients have experienced no difficulty in establishing a good oral intake.