Sternocleidomastoid Muscle Flap In Oral Cancer Tissue Defects After

Objective : To investigate the clinical outcome and prognosis of the stemocleidomastoid (SCM) myocutaneous flap for reconstruction of tissue defects in patients with oral carcinomas. We explored the relationship between SCM myocutaneous flap preparation and radical neck dissection, and summarized the introperative as well as postoperative cautions.Method: Forty-three patients underwent reconstruction with SCM myocutaneous flap were retrospectively reviewed, in the department of oral and maxillary surgery, 1st affiliated hospital, medical school of Zhejiang University from April 2001 to January 2007. All patients were performed the same operation, as "extending resection of oral carcinoma + lateral total neck dissention + reconstruction with SCM myocutaneous flap". Clinical data was obtained from different ways, such as the reference of clinical records, telephone follow-up and recheck information.1. The gender, age and location of onset, stage of TMN, and complications postoperatively were achieved by looking up the illness record.2. Consulting the pathological results and rereading the paraffin sections to summarize the etiological factors and the conditions of lymph nodes metastasis.3. The growth of flap, recurrence, metastasis, and complications were recorded during recheck phases or telephone follow-up.Results: 4 of 43 patients were died of recurrence after half a year postoperatively; 2 cases showed homolateral lymphonodes metastasis resulting in reoperation, and recheck the flap growth regularly; Complete SCM myocutaneous flap necrosis was never encountered; 4 cases were out of follow-up. There were no necrosis and recurrence in the rest 33 cases. 90% of patients were satisfied with their appearance, and had oral diet with no difficulty. Conclusion:1.Through observing the clinical practices and cases review, and contrasting different treatment methods by literature review, we believe that SCM myocutaneous flap with peduncular blood vessel is simple to perform and effectivein reconstruction of tissue defects for patients with oral carcinomas.2. After more than three years follow-up, we concluded that there was no influencein prognosis for patients with simultaneous preparation of SCM myocutaneous flapand perform of radical neck dissection.3.The preoperative evaluation of indication, intraoperative protection for bloodvessel pedicle of SCM myocutaneous flap and preservation for superior segment ofexternal jugular vein, and postoperative effective nursing play an crucial role insuccess.