Experience with the sternocleidomastoid myoperiosteal flap for reconstruction of subglottic and tracheal defects: modification of technique and report of long-term results.
Subglottic or tracheal reconstruction may be required in cases of subglottic stenosis, invasive thyroid carcinoma, or trauma. The sternocleidomastoid myoperiosteal flap uses clavicular periosteum on a muscle pedicle to provide vascularity. Clavicular periosteum is fibrous, durable, and will conform to the shape of the trachea, forming bone to provide stability to the airway. The procedure is relatively simple and involves single-staged reconstruction. After 4 years' experience with this flap, we present the results from a series of 11 patients who underwent subglottic or tracheal reconstruction with the sternocleidomastoid myoperiosteal flap. Ten of 11 patients were successfully decannulated. The average time from reconstruction to decannulation was 50.3 days. Follow-up ranged from 12 to 40 months. We also describe modifications of the initial technique that have been introduced to improve the flap's versatility and effectiveness.
Friedman
M
M
Department of Otolaryngology-Head and Neck Surgery, University of Illinois College of Medicine, Chicago.
Toriumi
D M
DM
Owens
R
R
Grybauskas
V T
VT
D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects; D007829:Laryngostenosis / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D007830:Larynx / Q000473:pathology; D008297:Male; D008722:Methods; D008875:Middle Aged; D009132:Muscles / Q000637:transplantation; D009361:Neoplasm Invasiveness; D010521:Periosteum / Q000637:transplantation; D011859:Radiography; D013524:Surgical Flaps; D013964:Thyroid Neoplasms / Q000473:pathology; D014132:Trachea / Q000473:pathology / Q000601:surgery*; D014140:Tracheotomy / Q000009:adverse effects