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Updated: Aug 6, 2026
Coronoid-Temporalis Pedicled Flap for Orbital Floor Defect Reconstruction
Published on: December 5, 2025
Operative Efficiency and Early Outcomes of Sternocleidomastoid Muscle Flap Versus Microvascular Free Flap for
Berrak Karatan1, Eray Uzunoğlu2, Tankut Uzun2
1Associate Professor, MD, Department of Plastic Surgery, İstanbul University Cerrahpaşa Medical School Hospital, İstanbul, Turkey.
Background:
Microvascular free flaps are standard for complex floor-of-mouth (FOM) reconstruction, but regional options may be preferable for selected soft-tissue defects not requiring bony reconstruction.
Purpose:
To compare operative time and early outcomes between sternocleidomastoid (SCM) muscle flaps and microvascular free flaps after oncologic FOM resection.
Study Design, Setting, Sample:
This retrospective cohort study was conducted at Bakırçay University Çiğli Training and Research Hospital. The sample included adult subjects who underwent oncologic FOM resection with immediate soft-tissue reconstruction between January 2022 and May 2026. Subjects were excluded if reconstruction was performed with other regional flaps, required bony reconstruction, or had missing outcome data.
Predictor Variable:
Primary FOM reconstruction technique, grouped as SCM muscle flap or microvascular free flap.
Main Outcome Variables:
Primary outcome was operative time. Secondary outcomes were length of stay (LOS), postoperative day of first oral intake, oral intake before discharge, and postoperative complications.
Covariates:
Age, sex, American Society of Anesthesiologists class, defect extent, and tumor stage.
Analyses:
Bivariate analyses used Mann-Whitney U, χ2, or Fisher's exact tests. Multivariable linear regression was performed for continuous outcomes.
Results:
The sample included 33 subjects: 17 SCM flaps and 16 free flaps. Operative time was 295.3 (99.9) and 456.8 (156.4) minutes for the SCM and free flap groups, respectively (P = .003). LOS was 13.2 (4.5) and 20.4 (6.1) days, respectively (P = .002). Intensive care unit (ICU) LOS was 0.4 (0.5) and 1.6 (0.6) days, respectively (P < .001). ICU admission occurred in 7 of 17 SCM subjects (41.2%) and 16 of 16 free flap subjects (100%) (P < .001). Postoperative day of first oral intake was 11.0 (6.6) and 12.3 (3.5) days, respectively (P = .1). In adjusted models, free flap reconstruction was associated with longer operative time (b = 204.2 minutes; P = .005), LOS (b = 6.7 days; P = .027), and ICU stay (b = 1.4 days; P < .001).
Conclusions And Relevance:
For selected FOM soft-tissue defects not requiring bony reconstruction, SCM muscle flap reconstruction was associated with shorter operative time, shorter hospitalization, and reduced ICU use with comparable early oral intake.