The Sternocleidomastoid Flap for Oral Cavity Reconstruction: Extended Indications and Technical Modifications

Chen, Hung-Chih; Chang, Hao-Sheng

doi:10.1016/j.joms.2015.07.027

Cited by 15 publications

(38 citation statements)

References 36 publications

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“…13 In the published literature, it is mentioned considerably less than arterial supply, although its importance is well-recognised. 4,8,17,23 Chen and Chang 8 quantified veins left to drain each flap, which other studies invariably failed to do. They concluded that the maximum number of veins should be left, to aid venous drainage.…”

Section: Venous Drainagementioning

confidence: 99%

“…Necrosis of the sternocleidomastoid flap is relatively high, although this is mainly accounted for by partial epithelial necrosis of the myocutaneous flap (Table 1). 3,6,8–10,20,24–26 Partial epithelial necrosis is difficult to prevent, with no conclusive evidence that preserving two or more pedicles to the flap prevents this. 4,9,17 Nor does the technique of suturing the skin to underlying muscle, to decrease the shearing of skin perforators, seem to prevent partial epithelial necrosis.…”

Section: Summary Of Reported Complicationsmentioning

confidence: 99%

“…However, they are unsuitable when prolonged general anaesthetic cannot be tolerated or when no microvascular team is available. 8,9 It also exposes an additional donor site to the risk of post-operative complications. 8…”

Section: Introductionmentioning

confidence: 99%

“…10,11 It can be too voluminous for some reconstructions, and there can be excessive adipose tissue, especially in females. 8,12 Therefore, a sternocleidomastoid flap may be preferable for some patients.…”

Section: Introductionmentioning

confidence: 99%

“…There is great variety in usage of the sternocleidomastoid flap in the literature, and there have been many new reports since the most recent general review in 2001. 1 As the use of free flaps is not without flaws, and a pectoralis major flap is not always an option, 8 a reliable alternative for reconstruction needs to be explored. Use of the sternocleidomastoid reconstructive flap should therefore be reviewed, taking into account the literature from the past 15 years.…”

Section: Introductionmentioning

confidence: 99%

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Revisiting the sternocleidomastoid flap as a reconstructive option in head and neck surgery

et al. 2019

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BackgroundThe sternocleidomastoid can be used as a pedicled flap in head and neck reconstruction. It has previously been associated with high complication rates, likely due in part to the variable nature of its blood supply.ObjectiveTo provide clinicians with an up-to-date review of clinical outcomes of sternocleidomastoid flap surgery in head and neck reconstruction, integrated with a review of vascular anatomical studies of the sternocleidomastoid.MethodsA literature search of the Medline and Web of Science databases was conducted. Complications were analysed for each study. The trend in success rates was analysed by date of the study.ResultsReported complication rates have improved over time. The preservation of two vascular pedicles rather than one may have contributed to improved outcomes.ConclusionThe sternocleidomastoid flap is a versatile option for patients where prolonged free flap surgery is inappropriate. Modern vascular imaging techniques could optimise pre-operative planning.

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Section: Venous Drainagementioning

confidence: 99%

Section: Summary Of Reported Complicationsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Revisiting the sternocleidomastoid flap as a reconstructive option in head and neck surgery

et al. 2019

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Reconstruction of Defects After Oral Cancer Surgery With the Superior Thyroid Artery Perforator Flap

Shi,

Lyu,

Wang

et al. 2024

The Laryngoscope

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ObjectiveThe superior thyroid artery perforator flap (STAPF) was previously presented as a type of locoregional pedicled flap for lateral facial and temple defects. In this study, we aimed to present our clinical experience with this flap for the reconstruction of soft tissue defects after oral cancer surgery.MethodsFrom February 2019 to December 2022, 24 patients with oral cancers at the School and Hospital of Stomatology, Peking University were included. Among these patients, 10 had cancers located in the tongue, five in the cheek inside the oral cavity, three in the lower gingiva, two in the upper gingiva, two in the floor of the mouth, and two in the palate. All patients were treated with extended tumor resection, neck dissection, and STAPFs to reconstruct the soft tissue defects. The details of the flap, including the flap size, venous flow, vascular pedicle length, the attatched muscle, and operation time were evaluated.ResultsThe dimensions of the flap skin paddle ranged from 3 cm × 5 cm to 6 × 14 cm. Fourteen patients had a closely concomitant superior thyroid vein perforator. Ten patients had non‐closely concomitant superior thyroid veins perforators which retrograde external jugular vein. The vascular pedicle length ranged from 5 to 9 cm. The infrahyoid muscle group or sternocleidomastoid muscle was included in the flaps in three patients. A total of 23/24 flaps were successful.ConclusionsThe STAPF is a viable reconstructive option for patients with oral cancers. It has the advantages of being robust, being thin, short operation time, and minor donor site complications.Level of Evidence4 Laryngoscope, 2024

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Sternocleidomastoid flap augmentation of the pharyngeal closure after total laryngectomy

Ibrahim

Wahba

Elbatawi

et al. 2017

Eur Arch Otorhinolaryngol

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The objective of the study was to evaluate the effect of sternocleidomastoid (SCM) flap augmentation of the pharyngeal closure after total laryngectomy on the incidence of pharyngocutaneous fistula (PCF). Thirty patients with T4a laryngeal carcinoma and none of them receiving primary radiotherapy previously were divided into two equal groups. Group A patients had SCM flap augmentation of the pharyngeal closure after total laryngectomy. Group B patients had the standard pharyngeal closure without augmentation. Both groups were followed up for 30 days postoperatively for the development of PCF. The use of the SCM added about extra 15 min to the surgical procedure in all patients (p < 0.001). The shape of the suture line of the neopharynx was horizontal in 14 patients (7 in each group) while it was T-shaped in the remaining 16 (8 in each group). Neck dissection was done in all patients except only two patients who previously had the neck dissection done in combination with partial laryngectomy. Three patients in each group developed PCF either early (10 days or less postoperatively) or late (more than 10 days but less than 30 days postoperatively). There was no statistically significant difference in the length of hospital stay between the two groups. The use of SCM flap did not reduce the incidence of PCF after total laryngectomy.

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The Sternocleidomastoid Flap for Oral Cavity Reconstruction: Extended Indications and Technical Modifications

Cited by 15 publications

References 36 publications

Revisiting the sternocleidomastoid flap as a reconstructive option in head and neck surgery

Revisiting the sternocleidomastoid flap as a reconstructive option in head and neck surgery

Reconstruction of Defects After Oral Cancer Surgery With the Superior Thyroid Artery Perforator Flap

Sternocleidomastoid flap augmentation of the pharyngeal closure after total laryngectomy

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