Supraperiosteal and subcostal pneumonolysis with a filling of the pectoral muscles may be defined as the freeing of the anterolateral portions of the upper ribs from their periosteum and intercostal muscles and the tucking of the pedicled pectoral muscles between the bared ribs externally and the periosteum, intercostal muscles, pleurae and lung internally.
This procedure is chiefly indicated for cavernous tuberculous or nontuberculous lesions that lie between the clavicle and the level of the third rib anteriorly. The relaxation and rest of the lung that are produced, with or without the aid of hemidiaphragmatic paralysis, tend to check the advance of the pulmonary lesions and to close pulmonary cavities, or to favor the development of fibrous tissue that will do so.
Classic extrapleural pneumonolysis consists in resection of a portion of a rib anteriorly or posteriorly, splitting of the deep periosteum and manual separation of the parietal pleura from the
ALEXANDER J. SUPRAPERIOSTEAL AND SUBCOSTAL PNEUMONOLYSIS WITH FILLING OF PECTORAL MUSCLES. Arch Surg. 1934;28(3):538-547. doi:10.1001/archsurg.1934.01170150115007