Split sternocleidomastoid muscle repositioning for correction of depressed post-tracheostomy scar and tracheal tug.

One important complication of tracheostomy procedure is the depressed scar left after the airway is removed. The problem is more challenging for the surgeon if tracheal tug accompanies. Six male patients with unaesthetic, depressed tracheostomy scars due to late removal of tracheostomy tubes after maxillofacial high-velocity gunshot injuries were treated. The patients' age ranged from 20 to 23 years, with an average age of 21 years. The mean tracheostomy tube removal time was 18 days (range, 9 to 34 days) postoperatively. The mean scar dimension was 13.4 mm x 14.4 mm x 4 mm (width, length, and depth, respectively). All patients showed tracheal tug and complained of swallowing discomfort. Under local anesthesia, split sternocleidomastoid muscle flaps were used bilaterally following excision of the skin scars and covered by adjacent skin flaps. The mean follow-up was 18 months. Cosmetic and functional results were satisfactory for all patients. Dysphagia disappeared in all patients following surgery. This technique is useful and easy to perform for reconstruction of complex post-tracheostomy scars.