The english name for this muscle is the muscle of the breast, the clavicle bone, and the breastlike process. The sternocleidomastoid perforator flap sciencedirect. Merge pdf files to create one new pdf file flexcil. Pectoralis major myocutaneous flap in head and neck surgery. Hypothesis the sternocleidomastoid scm flap seems to be a practicable but underestimated flap for reconstructive and plastic surgery of the head and neck. Indian dental academy leader in continuing dental education 2. Also, the muscle works with the scalene muscles in the neck during forced inspiration while breathing inhaling. A myocutaneous flap based on the sternocleidomastoid muscle appears useful in selected circumstances when preservation of the sternocleidomastoid does not compromise oncologic safety. Neck muscle anatomy a look at the sternocleidomastoid and scalenes 2. The sternocleidomastoid is located on each side of the neck and it is one of the largest muscles of the neck. Sternocleidomastoid muscle flap in preventing freys syndrome. Most documents on our website are posted in one or more of three formats. Additionally, the mesenteric wrap modification and prophylactic pectoralis major muscle have been described to further decrease anastomotic leaks and fistulae. The use of sternocleidomastoid flap in tonsil neoplasms.
In recent developments in the repair of large surgical defects where simple flap rotation may have been previously employed, myocutaneous flaps are being used because of functional advantages and to decrease the number of reconstructive procedures. The pdf file can be easily downloaded to your computer, enabling you to view it offline at your convenience. Jun 11, 2015 visible body sternocleidomastoid and the scalene muscles 1. In eight injected cadaveric dissections, the rescue flap was. Jan 12, 2015 chapter cervicofacial advancement flap introduction. Sternocleidomastoid muscle flap after parotidectomy ahmad abdelfattah nofal1 morsi mohamed2 1department of otorhinolaryngologyhead and neck surgery, zagazig university, zagazig, egypt 2department of general surgery, zagazig university, zagazig, egypt int arch otorhinolaryngol 2015. The results reported by the authors of each study suggest an objective decrease in freys syndrome when the scm flap was used, but there was no difference in the patients subjective reporting of symptoms.
The sternocleidomastoid muscle also known as sternomastoid is found in the neck. Rearrange individual pages or entire files in the desired order. Once you merge pdfs, you can send them directly to your email or download the file to our computer and view. Once files have been uploaded to our system, change the order of your pdf documents. Complete resection for torticollis head surgery neck surgery head and neck surgery. B lipodermal flaps post deepithelialisation after conification of the breast mould, note thickness of average 3 mm to 5mm. Objectives to determine in which situations the scm flap may represent a reliable alternative to other flaps used in head and neck surgery. Scm originates at the manubrium, the broad upper part of the sternum, and the clavicle or collarbone. Indications the scapula fasciocutaneous flap is now used infrequently due to the emergence of the forearm flap for oral and pharyngeal soft tissue reconstruction.
Listen to the audio pronunciation in the cambridge english dictionary. Sternocleidomastoid muscle and musculocutaneous flap s. Sternocleidomastoid flap local and regional flaps in. Complete sternocleidomastoid resection orange county surgeons. We use cookies to offer you a better experience, personalize content, tailor advertising, provide social media features, and better understand the use of our services.
Gomez nazim noor summary the experiences gained through the use of pectoralis major myocutaneous flap in reconstructive head and neck cancer surgery in 15 cases is presented. Sternocleidomastoid muscle radiology reference article. The superiorthyroidandsuper ficial cervical branches are carefully dis sected and protected. The sternocleidomastoid scm flap is conventionally raised as a superiorly or inferiorly based pedicled flap and may be either a muscular, myocutaneous or myoosseous flap. For this operation, the use of code 15734, muscle, myocutaneous, or fasciocutaneous flap, trunk, would be appropriate. The sternocleidomastoid scm receives its blood supply from several blood vessels and is commonly divided into thirds, the superior, middle, and inferior third.
Pdf the use of sternocleidomastoid flap in tonsil neoplasms. Visible body sternocleidomastoid and the scalene muscles. Sternocleidomastoid muscle and musculocutaneous flap. Pdf documents can contain links and buttons, form fields, audio, video, and business logic. The puncture site of the skin was 1 cm lateral to the sternocleidomastoid muscle, which is a conventional puncture site for cvc insertion using the classical supraclavicular approach without the ultrasound 3. The free adobe acrobat reader allows you to view, navigate, and print pdf files across all major computing platforms. Introduction most patients after either superficial or total parotidectomy develop facial deformity and frey syndrome, which leads to a significant degree of patient dissatisfaction. Five cases are reported where face and neck defects created by radical excisions of cancer were repaired using deltopectoral flaps. Ariyan editorial comment the designs and clinical applications are anatomically possible but have limited use with intraoral cancer, particularly if they have been irradiated. For all free flaps, the blood supply is reconstituted using microsurgical techniques to reconnect the artery brings blood into the flap and vein allows blood to flow out of the flap. Introduction most patients after either superficial or total parotidectomy develop facial deformity and frey syndrome, which leads to a significant degree of patient dissatisfaction objective assess the functional outcome and esthetic results of the superiorly based sternocleidomastoid muscle scm flap after superficial or total parotidectomy. Use 61510 craniectomy, trephination, bone flap craniotomy. It attaches to the mastoid process, a large, bony prominence on the base of the skull behind the ear, containing air spaces that connect with the middle ear cavity. Onestage reconstruction of nasal skin defects with local.
The rectangular sliding flap gives excellent results when used to reconstruct limited defects of the dorsum of the nose, from the root to the tip. Tongue reconstruction by means of the sternocleidomastoid. Osteocutaneous scapula free flap iowa head and neck protocols. Surgical procedures of complete sternocleidomastoid resection on during complete sternocleidomastoid resection, the sternocleidomastoid muscle in the neck is cut. Owens described the sternocleidomastoid scm flap in 1955 utilizing the entire length of skin overlying the muscle. Mar 27, 2015 the scm flap has many advantages over the smas flap, such as potentially decreased cosmetic defect, less risk of skin injuries during flap design, minimal risk of late skin necrosis, an ability to provide a larger width and length of muscle tissue that can be interposed, and ease with flap design and axis of rotation after parotidectomy. The use of the sternocleidomastoid flap helps reduce complic. The sternocleidomastoid perforator flap article in british journal of oral and maxillofacial surgery 497. The chondrocutaneous ear helical free flap for the. Its principal advantage lies in the singlestage repair of smaller oropharyngeal defects not exceeding 6 cm in.
They are responsible for head movement, stabilizing the upper region of the body, assisting in swallowing, helping to elevate the rib cage during inhalation, and more. An example of free flap could be a free toe transfer in which the great toe or the second toe is transferred to the hand to reconstruct a thumb. In this lesson, learn about the definition and function of the sternocleidomastoid muscle. Acs further advises its members to apply modifier 50 bilateral procedure to 15734 if performed on two sides of the body, and modifier 51 multiple procedure if performed through the same incision as the hernia repair. Sternocleidomastoid function, location, origin and pictures. First, a 4 6cm skinisland is outlined below the mastoid process, preserving its continuitywith underlyingmuscle fig2. Apr 23, 2020 the sternocleidomastoid muscle is innervated by the accessory nerve cranial nerve xi and direct branches of the cervical plexus c1c2.
In a craniotomy, a bone flap a piece of the skull is removed in order to allow the brain surgeon to reach the brain. The use of the ear as a donor site for a microvascular free flap, although not general consensus despite structural similarities. Sternocleidomastoid questions and study guide quizlet. Pdf files can be viewed using adobes free reader software. Mar 04, 2014 sternocleidomastoid myocutanious flap for intraoral reconstruction after resection certified fixed orthodontic courses by indian dental academy 1. Local flaps can be used, but this often results in a bulky nose with an unsatisfactory aesthetic appearance requiring secondary surgical procedures. The purpose of this study was to describe the use of the prophylactic pedicled sternocleidomastoid scm flap for prevention of anastomotic leaks and fistulae. You can merge pdf files as needed but you can only use two pdf files one time. In one patient the flap replaced a resected cervical esophagus. The cheek is the widest skin expanse of the face and is an important cosmetic and functional unit that provides a platform for crucial midface structures while supporting the lips, nose, and lower eyelids.
If you think its too much trouble to open two pdfs to read. They can be signed electronically, and you can easily view pdf files. Sternocleidomastoid muscle, along with the trapezius muscle, is invested by the superficial layer of the deep cervical fascia, which splits around it. Postexcision reconstruction of nasal skin defects may often be accomplished with local sliding flaps, which provide good skin, with perfect color match, in one operation.
Even if a neck dissection is not necessary, the space of potential spread of intraoral cancer would be violated. Sternocleidomastoid myocutanious flap for intraoral. Jun 26, 2016 sternocleidomastoid muscle and musculocutaneous flap s. Reconstruction of the fullthickness defect of the tip of nose, columella, and ala has always been a challenge. Wiley online library will be unavailable on saturday 27th february from 09.
The occipital artery is then ligated and divided,carefully pre serving the 11th nerve to. Reconstruction after orbital exenteration using gracilis. Original article successful repair of delayed esophageal. Microvascular surgery protocols general considerations.
Apr 15, 2015 the sternocleidomastoid muscle flexes the neck and helps with movement of the head. We report an uncommon indication for the use of a perforator based on scm flap with use of skin paddle as a transposition flap instead of an island flap, and identification and preservation of its blood supply using hand held doppler. A lipodermal flap outlined caudal to each breast pillar 3 cm in width and length in a patient undergoing unilateral reduction mammoplasty symmetrization. The sternocleidomastoid perforator flap request pdf. The use of sternocleidomastoid flap in tonsil neoplasms razvan hainaro. A unilateral contraction of the sternocleidomastoid muscle flexes the cervical vertebral column to the same side lateral flexion and rotates the head to the opposite side. Sternocleidomastoid muscle flap after parotidectomy. Although transoral surgery usually nee ds no recon. Jan 12, 2015 chapter 17 sternocleidomastoid flap introduction. Island flaps sliding on their own subcutaneous tissue deserve consideration. Craniotomy and craniectomy for severe brain injury.
If an additional clival approach is needed, the rescue flap pedicle becomes an impediment to this lower dissection and a standard flap should be raised. Objective assess the functional outcome and esthetic results of the superiorly based sternocleidomastoid muscle scm flap after superficial or total parotidectomy. This segmental blood supply enables the flap to be used in three possible ways. Perforator based sternocleidomastoid transposition flap for.
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