Sternocleidomastoid Myocutaneous Flap for Floor of Mouth Reconstruction after Resection of Squamous Cell Carcinoma

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Sternocleidomastoid Myocutaneous Flap for Floor of Mouth Reconstruction after Resection of Squamous Cell Carcinoma

Mohammad Adzwin Yahiya, Tong Ji, Chen-Ping Zhang: Sternocleidomastoid Myocutaneous Flap for Floor of Mouth Reconstruction after Resection of Squamous Cell Carcinoma. Mal. J. Oral Maxillofac. Surg. 2013; 11: 33–37.

Abstract: The sternocleidomastoid (SCM) muscle has been used as a myocutaneous flap where a skin paddle is taken over from the lower aspect of the muscle to satisfy the need for viable soft tissue in the reconstruction of oral cavity defects. The flap is not regularly used because it has been criticized on oncologic grounds, which are related to the safety of preserving this muscle when there are regional lymphatic metastases, unreliability of the skin paddle, limited size of the musculocutaneous unit, poor arc of rotation and introduction of free tissue transfer. The blood supply of the muscle is segmental in nature. Superior pedicle based flap is frequently used and the lower arterial pedicle is sacrificed to gain the full length of the muscle. The oral part of the skin undergoes partial or total necrosis as the skin paddle receives its blood supply from a segment which is very far from the superior arterial pedicle. The success rate of SCM myocutaneous flap can be improved by preserving the branch from the superior thyroid artery. The anatomic and technical basis of the flap is discussed in the context of a safe and reliable single-stage pedicled flap transfer in oral and maxillofacial reconstructive surgery.