Allow your head to gradually stop before reversing in counterclockwise circles. An inferiorly based island flap was used in 5 patients. The term sterno comes from the latin word sternon meaning breast or chest, the word cleido, refers to the clavicle, and the word mastoid comes from the greek mastos meaning breast and eidos meaning shape or form. Even if a neck dissection is not necessary, the space of potential spread of intraoral cancer would be violated. Sternocleidomastoid scm synonym musculus sternocleidomastoideus is a paired superficial muscle in the anterior portion of the neck.
Sternocleidomastoid muscle flap and freys syndrome. Sternocleidomastoid flaps the sternocleidomastoid flap was introduced in 1909 by jinau for facial reanimation. The sternocleidomastoid muscle has two heads which at the origin attach to the manubrium sterni and the medial third of the clavicle. Answers from specialists on sternocleidomastoid exercises.
Abstractsince its first description in 1908, the sternocleidomastoid flap scm has gained popularity in headandneck reconstruction as a. It remains an incredibly versatile flap by providing bulk, an area of hairless skin with excellent color match for the face, and opportunity to transpose periosteum or bone for correcting head and neck defects. Our pdf merger allows you to quickly combine multiple pdf files into one single pdf document, in just a few clicks. The sternocleidomastoid muscle scm is one of more than 20 pairs of muscles. Recently, interposing barriers between the overlying skin flap and the parotid bed, such as the sternocleidomastoid muscle scm flap, have been used to prevent this condition. Release of sternocleidomastoid muscle orthopaedicsone. Jun 26, 2016 sternocleidomastoid muscle and musculocutaneous flap s. Sternoclavicular joint definition of sternoclavicular. The vessels can be found using a hand held doppler in the triangle between the dorsal edge of the sternocleidomastoid muscle, the external jugular vein, and the medial part of the clavicle. Near the middle of the neck, they gradually blend into a. Owens described the sternocleidomastoid scm flap in 1955 utilizing the entire length of skin overlying the muscle. In spine surgery, it is usually reserved in the cases of revision after anterior cervical spine procedures. Together with the scm flap, the surgical technique added a wide.
Take deep consistent breaths while moving through these routines. The sternocleidomastoid muscle has significant application in the head and neck following radical ablative surgery about the mandible, face, and oral cavity. The sternocleidomastoid muscle originates from two locations. It can be used in the following ways to rehabilitate the paralyzed face, to correct a softtissue defect about the upper neck and oral cavity, and to protect the major arteries in the head. Cpt code 15734, 15732, 15740 muscle, mycoutaneos procedure. The sternocleidomastoid muscle is a twoheaded neck muscle, which true to its name bears attachments to the manubrium of sternum sterno, the clavicle cleido, and the mastoid process of the temporal bone mastoid it is a long, bilateral muscle of the neck, which functions to flex the neck both laterally and anteriorly, as well as rotate the head contralaterally to the side of. Mar 14, 2016 the anteriorly based partial thickness sternocleidomastoid scm muscle flap is among the various methods described to correct parotidectomy defects, but its indications and limitations are not clearly demonstrated in several reports. To the editorwe read with interest the article entitled sternocleidomastoid muscle myocutaneous flap for corrosive esophageal strictures by ananthkrishnan et al. This report describes a new technique for raising a scm flap based. The sternocleidomastoid is thick and narrow at its centre, and broader and thinner at either end. Here we will discuss its location in the body origin and insertion as well as its action the movement it makes. The sternocleidomastoid muscle is one of the largest and most superficial cervical muscles. The sternocleidomastoid muscle also known as sternomastoid is found in the neck.
A flap of scm can be used for the resection of the parotid gland. Also, the muscle works with the scalene muscles in the. Use of the sternocleidomastoid flap in association with a. Sternocleidomastoid muscle flap after parotidectomy.
The supraclavicular flap, also known as the epaulette flap is vascularized by the surpaclavicular artery, which branches off the transverse cervical artery. The primary actions of the muscle are rotation of the head to the opposite side and flexion of the neck. The sternocleidomastoid is innervated by the accessory nerve it is given the name sternocleidomastoid because it originates at the manubrium of the sternum sterno and the clavicle cleido, and. Manual of head and neck reconstruction using regional and free. Include any exams preformed under anesthesia positioning describe and provide or photos to illustrate p. A myocutaneous flap based on the sternocleidomastoid muscle appears useful in selected circumstances when preservation of the sternocleidomastoid does not compromise oncologic safety. British journal qj plastic surgerv 1983 36, 183186 1983 the trustees of british association of plastic surgeons the split sternocleidomastoid myocutaneous flap g. Pdf sternocleidomastoid muscle myocutaneous flap for. This idea that there is a separate unit like the biceps, the psoas, the latissimus is so perva. The english name for this muscle is the muscle of the breast, the clavicle bone, and the breastlike process.
The conventional pedicled sternocleidomastoid scm flap has a poor arc of rotation, limited volume and precarious vascularity. During the course of attending massage school at a new beginning school of massage, students are given a number of assignments that requiring research and writing. 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. Sternocleidomastoid myofascial flap for head and neck reconstruction sternocleidomastoid myofascial flap for head and neck reconstruction alvi, aijaz. The sternocleidomastoid flapits indications and limitations. There are a few ways you can relieve yourself of sternocleidomastoid pain. The sternocleidomastoid scm receives its blood supply from several blood vessels and is commonly divided into thirds, the superior, middle, and inferior third. Pdf on jan 1, 2011, tabinda hasan and others published variations of the.
Sternocleidomastoid muscle divides the neck into anatomical anterior and posterior triangles. Sternocleidomastoid muscle flap reconstruction during parotidectomy to prevent freys syndrome and facial contour deformity. The split sternocleidomastoid myocutaneous flap sciencedirect. The sternocleidomastoid muscle has a role in the body as big as its name. Mar 31, 2007 find code for rotation flap published on sat mar 31, 2007 question. The sternocleidomastoid muscle flap conley 1980 head.
Picture of sternocleidomastoid flap during parotidectomy. The sternocleidomastoid muscle has long been used for local reconstruction in the head and neck. 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. We report the use of the sternocleidomastoid muscle myocutaneous inlay flap. Sternocleidomastoid myocutanious flap for intraoral. Out of the two sh, the medial fleshy head arose from the anterolateral surface of the manubrium sterni, while the lateral tendinous head was arising from the sternum close to sternoclavicular joint, and both fused with each other near its attachment to the mastoid process. This article highlights the biodynamics of the sternocleidomastoid muscle and the clinical significance of its morphological variations. Visible body sternocleidomastoid and the scalene muscles. Use of the sternocleidomastoid flap in association. Sternocleidomastoid muscle flap preventing frey syndrome. The sternocleidomastoid muscle flap and its use in head and neck reconstruction.
The upper and lower attachments of the sternocleidomastoid muscle are divided. This segmental blood supply enables the flap to be used in three possible ways. Sternocleidomastoid myocutanious flap for intraoral reconstruction after resection certified fixed orthodontic courses by indian dental academy 1. We found the blood supply of the sternomastoidclavicle flap too tenuous for use in conjunction with a neck dissection. If you experience any of the above, or any other strange symptoms, do not do this stretch and notify your doctor.
That being said, stronger muscles can be bigger muscles, just maybe not as large as those built through muscle building techniques specifically. A unilateral contraction of the sternocleidomastoid muscle flexes the cervical vertebral column to the same side lateral flexion and rotates the head to. Sternocleidomastoid flap local and regional flaps in. Start small and slowly work into larger circles, always moving slowly. The use of the sternocleidomastoid scm muscle in the repair of soft tissue defects arising after surgery for neoplasms of the head and neck has been a subject of controversy. Sternocleidomastoid muscle radiology reference article. Sensory branches of the cervical plexus merge dorsally to the muscle at the erbs point punctum nervosum which can be used as a place of puncture for local anesthesia.
It travels obliquely across the side of the neck and inserts at the mastoid process of the temporal bone of the skull. To compare the outcomes of using multiple kinds of sternocleidomastoid flap or free flaps to repair defects after oral cancer surgery. The study proposed an algorithm for different uses of scm flap repair according to site and size of funnel perforation. Objective assess the functional outcome and esthetic results of the superiorly based sternocleidomastoid muscle scm flap after superficial or total parotidectomy. Hypothesis the sternocleidomastoid scm flap seems to be a practicable but underestimated flap for reconstructive and plastic surgery of the head and neck. This study was done to test the aesthetic outcome of this method, its indications and limitations. Anteriorly based partial thickness sternocleidomastoid muscle. Ariyan editorial comment the designs and clinical applications are anatomically possible but have limited use with intraoral cancer, particularly if they have been irradiated.
Cpt code 15734, 15732, 15740 muscle, mycoutaneos procedure 15570 formation of direct or tubed pedicle, with or without transfer. Stop if you feel dizzy, nautious, get a headache, or have numbness or vision changes. Indications discuss indications and more general concerns. Objectives to determine in which situations the scm flap may represent a reliable alternative to other flaps used in head and neck surgery. My doctor did a major ear surgery on a man who has radiation necrosis of the temporal bone, atresia due to radiation of inner ear, necrosis of canal wall due to radiation. Visible body sternocleidomastoid and the scalene muscles 1. Also, the muscle works with the scalene muscles in the neck during forced inspiration while breathing inhaling. Sternocleidomastoid definition of sternocleidomastoid by. Sternocleidomastoid definition is a thick superficial muscle on each side of the neck that arises by one head from the first segment of the sternum and by a second from the inner part of the clavicle, that inserts into the mastoid process and occipital bone, and that acts especially to bend, rotate, flex, and extend the head called also sternomastoid. Apr 15, 2015 the sternocleidomastoid muscle flexes the neck and helps with movement of the head. Sternocleidomastoid muscle, along with the trapezius muscle, is invested by the superficial layer of the deep cervical fascia, which splits around it. Combining the old technique of the flap with the approach of using an integra template together with a skin graft allowed us to obtain a. Sternocleidomastoid muscle and musculocutaneous flap s. Sternocleidomastoid muscle and musculocutaneous flap.
The results of healing of the sternocleidomastoid myocutaneous flap in 22 patients operated upon because of cancer of the tongue and floor of the mouth are presented. Mar 04, 2014 sternocleidomastoid myocutanious flap for intraoral reconstruction after resection certified fixed orthodontic courses by indian dental academy 1. The sternocleidomastoid muscle flexes the neck and helps with movement of the head. This muscle binds the skull to the sternum and clavicle. The sternocleidomastoid perforator flap request pdf. Sternocleidomastoid muscle flap after parotidectomy ahmad abdelfattah nofal1 morsi mohamed2 1department of otorhinolaryngologyhead and neck surgery, zagazig university, zagazig, egypt. The sternocleidomastoid muscle scm is an important landmark in the neck which divides it into an anterior and a posterior triangle. Additionally, the mesenteric wrap modification and prophylactic pectoralis major muscle have been described to further decrease anastomotic leaks and fistulae.
Immediate reconstruction of mandibular defects with a. Neck muscle anatomy a look at the sternocleidomastoid and scalenes 2. 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 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. If you stretch the trapezius muscle, it can also stretch the sternocleidomastoid one and help you with pain reduction. The aim of the present study was to assess the outcome of using sternocleidomastoid scm muscle flap for reinforcement of primary repair of hpce funnel injury.
The purpose of this study was to evaluate the impact of using this flap on frey syndrome. This report describes a new technique for raising a scm flap based on the perforating vessels of the superior thyroid vascular pedicle. Pdf strictures at the pharyngoesophageal junction represent a subgroup of. The use of sternocleidomastoid muscle flap has firstly been described in 1909. Its principal advantage lies in the singlestage repair of smaller oropharyngeal defects not exceeding 6 cm in. Smart flap of sternocleidomastoid muscle in anterior cervical spine. Sternocleidomastoid muscle flap in preventing freys. The purpose of this study was to describe the use of the prophylactic pedicled sternocleidomastoid scm flap for prevention of anastomotic leaks and fistulae.
This is done by tilting your head from the right to the left side. Pdf sternocleidomastoid muscle flap after parotidectomy. Learn vocabulary, terms, and more with flashcards, games, and other study tools. Sternocleidomastoid exercises answers on healthtap. Combining the old technique of the flap with the approach of using an integra template together with a skin graft allowed us to obtain a satisfac. To determine in which situations the scm flap may represent a reliable alternative to other flaps used in head and neck surgery. Discussion this unique muscle has a high relevance in cases of painful myofascial trigger points, physiology of neck equilibrium, muscle flap harvests and the vital structures lying under its cover. In this lesson, learn about the definition and function of the sternocleidomastoid muscle.
Indian dental academy leader in continuing dental education 2. Manual of head and neck reconstruction using regional and free flaps. Picture of sternocleidomastoid flap during parotidectomy to. Abstract the use of sternocleidomastoid muscle flap has firstly been. Sternocleidomastoid advanced holistic healing arts.
This flap can be used as a muscle, myocutaneous or a myoosseous flap. By tom myers, soft tissue practitioner some readers may be familiar with the anatomy trains myofascial meridians idea. Use of the sternocleidomastoid flap in association with. Knowledge of the surgical anatomy and the landmarks to find the facial nerve are the key to preserving facial nerve function. The use of the sternocleidomastoid flap helps reduce. One trapeziusscapular flap was used and it succeeded. Sternocleidomastoid myocutaneous flap for intraoral. Mar 27, 2015 introduction most patients after either superficial or total parotidectomy develop facial deformity and frey syndrome, which leads to a significant degree of patient dissatisfaction. Unusual third head of the sternocleidomastoid muscle. The trapeziusscapular flap had too short an arc of rotation to be used for defects other than those in the horizontal ramus. Sternocleidomastoid muscle flap reconstruction during.
611 389 1278 642 946 603 1281 193 960 1393 290 1236 14 815 183 311 1218 60 949 1331 938 444 1115 633 715 1322 507 276 1558 32 1194 820 448 233 1139 791 341 1049 225 1474