Sternocleidomastoid flap following parotidectomy

Area of Science:

• Head and Neck Surgery
• Plastic and Reconstructive Surgery
• Oncology

Background:

• The sternocleidomastoid (SCM) muscle flap has historically had restricted use in head and neck reconstruction due to concerns about its blood supply and proximity to disease.
• Previous applications focused on improving cosmesis for benign parotid tumors.

Purpose of the Study:

• To evaluate the utility and safety of the SCM muscle flap for reconstruction in patients with benign and malignant parotid disease.
• To expand the indications for SCM flap use in head and neck cancer resections.

Main Methods:

• Retrospective review of 31 patients undergoing SCM muscle flap reconstruction for parotid disease (benign and malignant).
• Flaps were utilized in superiorly or inferiorly based configurations.
• Assessment of flap function in providing soft tissue contour, coverage, and closure of fistulas.

Main Results:

• The SCM muscle flap was successfully used in 31 patients with benign and malignant parotid disease.
• Flaps provided essential soft tissue contour and coverage for facial nerves and grafts.
• The flaps served as a healthy bed for skin grafts and aided in closing salivary fistulas.
• No complications were attributed to the SCM flaps in this series.

Conclusions:

• The SCM muscle flap is a safe and versatile reconstructive option for parotid disease, including malignant conditions.
• Its use can be expanded beyond cosmetic improvements to address functional deficits and facilitate wound healing.
• The SCM flap offers significant benefits in head and neck reconstruction without compromising patient safety.