Charles G A, Hamaker R C, Singer M I
Laryngoscope. 1987 Aug;97(8 Pt 1):970-4.
The sternocleidomastoid myocutaneous flap has several applications for reconstruction of defects about the head and neck. It is used for augmentation of facial defects, carotid artery protection, and repair of oral cavity defects. Additional reconstructive efforts suggest the sternocleidomastoid myocutaneous flap can be used for facial reanimation and as an osteomyocutaneous flap incorporating the clavicle for mandibular reconstruction. Reports of unreliable viability and resection of the sternocleidomastoid muscle during neck dissection decreases the applicability of the flap. Twenty-seven sternocleidomastoid flaps were used in 26 patients for head and neck reconstruction. In contrast to the reported 40% to 50% incidence of superficial slough or total flap necrosis, three (11%) flaps developed superficial (cutaneous) slough while two patients developed inclusion cysts. The technique includes elevation of the sternocleidomastoid muscle with the overlying platysma and skin originally described by Owens. The procedure is modified by removing the epithelium on the tunneled portion of the flap. This allows the flap to be used as a one-stage method of reconstruction without sacrificing the additional blood supply from the platysma and overlying dermis.
胸锁乳突肌肌皮瓣在头颈部缺损重建中有多种应用。它用于面部缺损的修复、颈动脉保护以及口腔缺损的修复。更多的重建研究表明，胸锁乳突肌肌皮瓣可用于面部功能重建，也可作为一种包含锁骨的骨肌皮瓣用于下颌骨重建。有报道称，在颈部清扫术中胸锁乳突肌的存活可靠性及切除情况会降低该皮瓣的适用性。26例患者共使用了27个胸锁乳突肌皮瓣进行头颈部重建。与报道的40%至50%的浅表性坏死或皮瓣完全坏死发生率不同，有3个（11%）皮瓣出现了浅表（皮肤）坏死，2例患者出现了包涵囊肿。该技术包括按照欧文斯最初描述的方法，将胸锁乳突肌与覆盖其上的颈阔肌和皮肤一并掀起。通过去除皮瓣隧道部分的上皮对该手术进行改良。这使得皮瓣能够作为一种一期重建方法使用，而无需牺牲来自颈阔肌和覆盖真皮的额外血供。
