The compound sternal flap for laryngeal reconstruction

Area of Science:

• Head and Neck Surgery
• Reconstructive Surgery
• Oncologic Surgery

Background:

• Near-total laryngectomy and radiation therapy pose significant reconstructive challenges.
• Maintaining airway patency and voice function are critical post-laryngectomy goals.
• Limited regional flap options exist for complex laryngeal defects.

Observation:

• A compound flap, incorporating sternocleidomastoid muscle with sternal periosteum and anterior cortex, was successfully transferred.
• This flap provided a rigid structural replacement for the resected larynx.
• The flap was used in conjunction with a temporary laryngeal endoprosthetic stent.

Findings:

• The sternocleidomastoid compound flap achieved a one-stage reconstruction.
• It successfully replaced the subtotal larynx, preventing airway collapse and stenosis.
• The reconstruction obviated the need for postoperative tracheostomy and nasogastric feeding.
• Excellent functional results, including voice preservation, were reported.

Implications:

• This flap offers a reliable regional alternative to complex microsurgical reconstructions.
• It presents a viable option for patients with prior radiation therapy.
• The technique may improve functional outcomes and reduce postoperative morbidity in laryngeal reconstruction.