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Role of sternomastoid muscle interposition in concomitant transoral oncologic resection and neck dissection
Author(s) -
Panda Smriti,
Thakar Alok,
Sikka Kapil,
Sharma Suresh C.
Publication year - 2019
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.25753
Subject(s) - medicine , swallowing , surgery , concomitant , neck dissection , sternocleidomastoid muscle , head and neck , dissection (medical) , distant metastasis , transoral robotic surgery , head and neck cancer , metastasis , radiation therapy , cancer
Background To report the experience with sternomastoid (SM) myofascial flap for reconstruction/buttressing of lateral pharyngeal wall and floor of mouth defects following transoral onco‐surgery. Methods Prospectively collected data from February 2012‐January 2018. SM flap harvested as a superiorly based flap supplied by the occipital artery and consisting of only the anterior SM head. Results A total of 42 patients were included (TORS, n = 40; TOUSS, n = 2). Three of 42 patients developed transient pharyngo‐cervical communications with subsequent spontaneous healing. Flap loss was not noted in any patient. Forty‐one of 42 patients resumed normal swallowing and one patient was PEG dependent. Fifteen of 42 patients had pretreatment metastatic neck nodes. No patient however developed nodal recurrence over a median follow‐up of 30 months. Conclusion The modified SM flap as reported here is a simple locally available reconstructive option when undertaking transoral surgery. Oncological concerns may however limit its use in situations with large nodal metastasis or extracapsular spread.