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Method to prevent cheek depression using an island sternocleidomastoid muscle flap with the middle pedicle as a feeding vessel in immediate reconstruction of the facial nerve with the sural nerve following resection of a parotid gland tumor

  • Matsuura, Naoki (Department of Plastic and Reconstructive Surgery, Yokohama Municipal Citizen's Hospital) ;
  • Sakuma, Hisashi (Department of Plastic and Reconstructive Surgery, Yokohama Municipal Citizen's Hospital) ;
  • Shimono, Ayano (Department of Plastic and Reconstructive Surgery, Yokohama Municipal Citizen's Hospital)
  • Received : 2020.04.23
  • Accepted : 2020.07.29
  • Published : 2021.03.15

Abstract

Many surgeons have demonstrated the validity of sternocleidomastoid muscle flaps for the reconstruction of head and neck tumors. We present a case in which we used an island sternocleidomastoid muscle flap to reconstruct a cheek depression after excision of a malignant parotid tumor. A 44-year-old woman presented with a right malignant parotid tumor. We performed total resection of the parotid gland and facial nerve with the sural nerve and reconstructed the facial nerve and cheek depression with an island sternocleidomastoid muscle flap. The sternal head of the right sternocleidomastoid muscle was cut at the cranial and caudal segments to elevate it as an island flap. We used the superior thyroid artery as the sole pedicle for the island muscle flap. At 1 year and 3 months after the operation, the mimic muscles had gradually recovered and progressed without complications such as Frey syndrome, cervical motor dysfunction, or concave deformation of the neck and cheeks.

Keywords

References

  1. Zhang X, Liu F, Lan X, et al. Combined submandibular gland flap and sternocleidomastoid musculocutaneous flap for postoperative reconstruction in older aged patients with oral cavity and oropharyngeal cancers. World J Surg Oncol 2014;12:259. https://doi.org/10.1186/1477-7819-12-259
  2. Sanchez JA, Panait L. Surgical repair of long-segment cervical esophageal injury with a sternocleidomastoid myocutaneous flap. Ann Thorac Surg 2012;94:305-7. https://doi.org/10.1016/j.athoracsur.2012.02.006
  3. Khazaeni K, Rajati M, Shahabi A, et al. Use of a sternocleidomastoid myocutaneous flap based on the sternocleidomastoid branch of the superior thyroid artery to reconstruct extensive cheek defects. Aesthetic Plast Surg 2013;37:1167-70. https://doi.org/10.1007/s00266-013-0216-z
  4. Berg T, Jonsson L, Engstrom M. Agreement between the Sunnybrook, House-Brackmann, and Yanagihara facial nerve grading systems in Bell's palsy. Otol Neurotol 2004;25:1020-6. https://doi.org/10.1097/00129492-200411000-00027
  5. Motomura H, Yamanaka K, Maruyama Y, et al. Facial nerve reconstruction using a muscle flap following resection of parotid gland tumours with thorough recipient bed preparation. J Plast Reconstr Aesthet Surg 2011;64:595-601. https://doi.org/10.1016/j.bjps.2010.08.027
  6. Tanaka K, Okazaki M, Homma T. Nerve grafting for a facial nerve defect with a focus on blood flow in the graft bed. Facial Nerve Res Jpn 2016;36:135.
  7. Mathes SJ, Nahai F. Classification of the vascular anatomy of muscles: experimental and clinical correlation. Plast Reconstr Surg 1981;67:177-87. https://doi.org/10.1097/00006534-198167020-00007
  8. Kierner AC, Aigner M, Zelenka I, et al. The blood supply of the sternocleidomastoid muscle and its clinical implications. Arch Surg 1999;134:144-7. https://doi.org/10.1001/archsurg.134.2.144
  9. Leclere FM, Vacher C, Benchaa T. Blood supply to the human sternocleidomastoid muscle and its clinical implications for mandible reconstruction. Laryngoscope 2012;122:2402-6. https://doi.org/10.1002/lary.23430
  10. Hu KS, Song WC, Kim SH, et al. Branching patterns of the arterial branches supplying the middle vascular pedicle of the sternocleidomastoid muscle: a topographic anatomical study with surgical applications for the use of pedicles osteomuscular flaps. Surg Radiol Anat 2006;28:7-12. https://doi.org/10.1007/s00276-005-0053-0