title: Use of the versatile sternocleidomastoid flap in oral and maxillofacial surgery: our experience.
abstract: Our aim was to evaluate the reliability of sternocleidomastoid (SCM) flaps in the reconstruction of defects after oral and maxillofacial resections, and summarise the ways in which morbidity can be reduced. We retrospectively enrolled 65 patients who had malignant tumours resected, and assessed the postoperative viability of the SCM flap. All complications were recorded during a follow up period of 1-64 months. We also investigated the relation between recurrence in regional lymph nodes and their preoperative histological state. The conventional SCM flap, the split SCM flap with only the sternal head, and the SCM flap with a half-thickness clavicular graft, were used to repair different defects. No flaps necrosed completely, and in only 5 cases was there partial loss of the skin paddle. The skin paddle avulsed in 2 cases 2 patients developed wound infections. Only 9 patients developed complications (14%, 9/65). Use of the split SCM flap overcomes the problem of bulk. The combination of the SCM flap and clavicular bone enables early dental implantation. The SCM flap is convenient, reliable, and technically easy for the reconstruction of intraoral or mandibular tissue loss. Preservation of the branch of the superior thyroid artery and precise surgical technique contribute to a higher success rate.
authors.affiliation: Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, College of Medicine, Zhejiang University, 79 Qingchun Road, Hangzhou, Zhejiang Province 310003, PR China. Electronic address: zyweidong@126.com.
authors.forename: Dong
authors.initials: D
authors.lastname: Wei
authors.forename: Jian-hua
authors.initials: JH
authors.lastname: Liu
authors.forename: Wen-quan
authors.initials: WQ
authors.lastname: Zhao
authors.forename: Hui-yong
authors.initials: HY
authors.lastname: Zhu
authors.forename: Zhi-yong
authors.initials: ZY
authors.lastname: Li
authors.forename: Hui-ming
authors.initials: HM
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016025:Bone Transplantation / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary / Q000601:surgery; D002968:Clavicle / Q000601:surgery; D003758:Dental Implantation, Endosseous; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006801:Humans; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008334:Mandible / Q000601:surgery; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology / Q000601:surgery*; D064827:Myocutaneous Flap / Q000098:blood supply / Q000637:transplantation; D009334:Neck Muscles / Q000098:blood supply / Q000637:transplantation*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D013524:Surgical Flaps / Q000098:blood supply / Q000637:transplantation*; D013530:Surgical Wound Infection / Q000209:etiology; D020858:Tissue and Organ Harvesting / Q000379:methods; D060053:Transplant Donor Site / Q000601:surgery; D016896:Treatment Outcome
keywords: Oral reconstruction; Sternocleidomastoid flap; Superior thyroid artery