Subclavicular approach in head and neck reconstruction with the latissimus dorsi musculocutaneous flap

As an alternative procedure in transferring the pedicled latissimus dorsi musculocutaneous flap to the head and neck, we have devised a subclavicular approach and applied it successfully in our clinic. This approach reduces the distance of the transfer and leaves no bulkiness over the clavicle. The subclavian vessels, the brachial plexus and the cervical pleura are retracted safely beyond the periosteum during the procedure, and the pedicle of the flap is protected under the clavicle postoperatively.