To the Editor.—I have been most interested in the recent articles1,2 on pectoralis myocutaneous flap (PMF) modifications published in the Archives. Also, I would like to compliment Dr Fee for his commentary concerning the various methods of pharyngeal and esophageal reconstruction.3 One of the major points these authors make is that a less bulky flap will avoid functional problems (deglutition and esophageal speech) after reconstruction.
It is particularly important, however, to analyze and compare the techniques for PMF modifications.
Robertson and Robinson1 used a technique outlined by Sharzer et al,4 in which the incision is started superiorly near the manubrium, descends parasternally, and then curves laterally in the inframammary fold. While this is probably the most cosmetically pleasing design, it "burns a bridge," insofar as a deltopectoral flap (DPF) cannot be used if the need arises in the future. On the other hand, the incision
STIERNBERG CM. Pectoralis Myocutaneous Flap Modifications. Arch Otolaryngol. 1985;111(3):208. doi:10.1001/archotol.1985.00800050102017