The sternocleidomastoid muscle flap.

The sternocleidomastoid muscle has significant application in the head and neck following radical ablative surgery about the mandible, face, and oral cavity. It can be used in the following ways to rehabilitate the paralyzed face, to correct a soft-tissue defect about the upper neck and oral cavity, and to protect the major arteries in the head and neck. (a) It may be transposed with a segment of the clavicle and/or sternum as a composite pedicle flap for reconstruction of the mandible. (b) It may be transposed into the lower cheek and jaw to reconstruct a mandibular defect. (c) It may be transposed into the anterior floor of the mouth as a myocutaneous flap following major ablative surgery to assist in correcting the defect and rehabilitating the oral cavity. (d) It may assist in facial paralysis to reanimate the lower third of the face. (e) It may be used to reinforce a suture line and protect the carotid and innominate arteries. (f) It may assist in shoulder elevation following poliomyelitis when transposed to the acromial process of the clavicle.