• Archives of Plastic Surgery
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• v.48 no.2
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• pp.213-216
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• 2021

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.

• Korean Journal of Head & Neck Oncology
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• v.32 no.2
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• pp.79-83
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• 2016

Chyle fistula is one of the complications of neck dissections. Although immediate surgical repair seems to be the best choice when chyle leakage is observed during the operation, some operators can be embarrassed when chyle leakage is heavy and not controlled during surgery. In this case, chyle leakage was occurred after extensive resection of lymph nodes in left level IV, and was not controlled in any way. The clavicular head of sternocleidomastoid muscle was dissected and inferior-based muscular flap was rotated to cover the suspected region of fistula orifice. Amount of drainage was checked less than 20 ml per day in the following days, and drain tube was taken out on the 3rd postoperative days. We present the technique using the inferior based sternocleidomastoid muscle flap for intraoperative management of chyle leakage not easily controlled.

• Korean Journal of Head & Neck Oncology
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• v.3 no.1
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• pp.37-54
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• 1987

The aim of surgery for all parotid masses is directed toward total removal of the tumor with adequate safe margins of adjacent normal tissue and preservation of the facial nerve whenever possible. Reconstructive procedures following parotidectomy for benign or low grade malignant lesions are most commonly necessary if soft tissue deficits appear at the angle of the mandible below the earlobe as a major cosmetic deformity. This is a report of Z4 cases with a diagnosis of parotid tumor who were treated using various surgical procedures at Department of Plastic and Reconstructive Surgery, Hanyang University Hospital over the period of 4 years from January, 1983 to December, 1986. Among 24 cases, 11 cases were reconstructed by Sternocleidomastoid muscle flap at the same time that extirpative surgery is outlined. The advantage of Sternocleidomastoid muscle flap is the coverage of the facial nerve, so adhesion between the facial nerve and skin was prevented. Absorption and loss of bulk was not found such as dermofat graft. It was a simple method. Neither donor site defect nor sternocleidomastoid muscle deformity was developed. Sternocleidomastoid muscle flap have been found satisfactory in maintaining filled-out soft tissue hollows with good result cosmetically and functionally.

• Journal of Gastric Cancer
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• v.20 no.4
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• pp.454-460
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• 2020

Tracheo-gastric conduit fistula is an extremely rare but severe complication that is difficult to manage. Conservative care, esophageal or tracheal stent placement, or cutaneomuscular flaps have been suggested; however, no definite treatment has been proven. We report a case of tracheo-gastric conduit fistula that occurred after a minimally invasive radical three-field esophagectomy. Following the primary surgery, the diagnosis was made while evaluating the patient's frequent aspiration and coughing. Conservative management failed, and a surgical correction was undertaken to identify the multifocal mucosal defect and exposed tracheal ring. A sternocleidomastoid muscle rotation flap and subsequent Histoacryl injection into the remaining fistula were performed, and the fistula was successfully managed.

• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.27 no.2
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• pp.134-137
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• 2016

A Killian-Jamieson diverticulum (KJD) is an unfamillar and unusual cervical esophageal diverticulum. This diverticulum originates on the anterolateral aspect of the esophagus through the Killian-Jamieson's area that is formed between cricopharyngeal muscle and the lateral to longitudinal esophageal muscle. Recently, we experienced a patient who was found outpouching lesion on lateral side of left esophagus on the duodenoscopy. Then, a barium esophagography performed and in left lateral position demonstrated a left-sided diverticulum with a frontal projection, highly suggestive of a KJD. There are two ways of surgical approach to manage the KJD. First is external approach, another one is endoscopic approach. In common, external approach has been recommended for the treatment of KJD because of concern of nerve injury. We present a case of KJD that underwent external approach and sternocleidomastoid muscle flap in the management of KJD.

• Archives of Craniofacial Surgery
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• v.12 no.1
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• pp.37-42
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• 2011

Purpose: Cancer arising from the external auditory canal is a rare disease. A lesion that seems harmless in someway, can be lethal when inadequately excised, the tumor may infiltrate nerves, the parotid and auditory tissues before re-invading the skin. Wide resection of the lesion surrounding the structure and reconstruction with an adequate plan is crucial for the treatment of this disease. Methods: Two patients with external auditory canal cancer were treated with muscle flaps and skin grafts. Lateral temporal bone resection (LTBR) was performed for complete resection of the cancer. The defect cavity was obliterated with highly vascularized tissue using pedicled sternocleidomastoid muscle, and temporalis muscle individually, combined with full thickness skin graft for covering the skin defect of the ear. Results: Clear resection margin was obtained, and both patients showed disease free survival during the follow up. There was no complications of hematoma, infection, flap loss, or wound problem in both patients. Both patient received radiation therapy, there was no osteoradionecrosis or any other complication related to radiation therapy. Conclusion: Utilizing pedicled muscle flaps for managing defects after wide resection of the external auditory canal cancer is an effective method for managing this difficult disease.

• Korean Journal of Head & Neck Oncology
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• v.37 no.1
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• pp.63-66
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• 2021

Supracricoid partial laryngectomy (SCPL) with cricohyoidoepiglottopexy (CHEP) or cricohyoidopexy (CHP) involves the removal of the whole thyroid cartilage, both true and false vocal cords, the ventricles, and the paraglottic spaces, sparing the cricoid cartilage, hyoid bone, and at least one functional and mobile cricoarytenoid unit. Reconstruction is performed by suturing of the cricoid cartilage up tightly to the hyoid bone, so trachea-releasing procedures are needed to prevent leakage at anastomosis site. In case of advanced tranglottic cancer invading tracheal tracheal wall, we need to perform additional circumferentrial circumferential tracheal wall resection. However, when we perform SCPL, circumferential resection of tracheal wall is limited because SCPL procedure itself needs releasing of tracheal length. We report a case of advanced transglottic cancer involving tracheal wall treated with induction chemotherapy and SCPL including tracheal wall resection with reconstruction of tracheal defect by sternocleidomastoid muscle flap covered with skin graft.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.13 no.2
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• pp.144-152
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• 1991

Various muscular flaps are used in oral and maxillofacial reconstructive surgery for the defects caused by tumor resection and trauma or for the correction of head and neck deformities. The sternocleidomastoid(SCM) muscle may be widely used as a muscular or myocutaneous flap in these lesion. The authors used SCM muscular flap for the expected parotid defect following benign tumor related conservative parotidectomy in three cases. We expected that prevention of post-operative facial deformity, reduction of dead-space and protection of denuded facial nerve etc. is lead by SCM muscular flap. But the total SCM flap can lead to some complications such as "flat neck deformity", limitation of neck movement and overcontouring of parotid defect. Therefore, the authors used split pedicled SCM muscular flap and it lead good favorable results of post-operative functional and esthetic problems.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.40.1-40.7
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• 2015

Surgical procedures for parotidectomy had been developed to gain adequate approach, prevent morbidity of nerve, and give esthetic satisfaction. We performed two cases of parotidectomy through facelift incision. One case was reconstructed with superficial musculoaponeurotic system (SMAS) flap and sternocleidomastoid (SCM) muscle rotated flap at the parotid bed. In second case, same procedures were performed, but collagen membrane was additionally implanted for prevention of Frey's syndrome. After surgery, two cases showed esthetic results without neck scar and hollow defect on parotid bed area.