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Br J Oral Maxillofac Surg ; 51(8): 742-6, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-23701831

RESUMO

Our aim was to evaluate the reliability of sternocleidomastoid (SCM) flaps in the reconstruction of defects after oral and maxillofacial resections, and summarise the ways in which morbidity can be reduced. We retrospectively enrolled 65 patients who had malignant tumours resected, and assessed the postoperative viability of the SCM flap. All complications were recorded during a follow up period of 1-64 months. We also investigated the relation between recurrence in regional lymph nodes and their preoperative histological state. The conventional SCM flap, the split SCM flap with only the sternal head, and the SCM flap with a half-thickness clavicular graft, were used to repair different defects. No flaps necrosed completely, and in only 5 cases was there partial loss of the skin paddle. The skin paddle avulsed in 2 cases 2 patients developed wound infections. Only 9 patients developed complications (14%, 9/65). Use of the split SCM flap overcomes the problem of bulk. The combination of the SCM flap and clavicular bone enables early dental implantation. The SCM flap is convenient, reliable, and technically easy for the reconstruction of intraoral or mandibular tissue loss. Preservation of the branch of the superior thyroid artery and precise surgical technique contribute to a higher success rate.


Assuntos
Neoplasias Bucais/cirurgia , Músculos do Pescoço/transplante , Procedimentos de Cirurgia Plástica/métodos , Retalhos Cirúrgicos/transplante , Adulto , Idoso , Idoso de 80 Anos ou mais , Transplante Ósseo/métodos , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas/secundário , Carcinoma de Células Escamosas/cirurgia , Clavícula/cirurgia , Implantação Dentária Endóssea , Feminino , Seguimentos , Sobrevivência de Enxerto , Humanos , Metástase Linfática/patologia , Masculino , Mandíbula/cirurgia , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Retalho Miocutâneo/irrigação sanguínea , Retalho Miocutâneo/transplante , Músculos do Pescoço/irrigação sanguínea , Recidiva Local de Neoplasia/patologia , Estudos Retrospectivos , Retalhos Cirúrgicos/irrigação sanguínea , Infecção da Ferida Cirúrgica/etiologia , Coleta de Tecidos e Órgãos/métodos , Sítio Doador de Transplante/cirurgia , Resultado do Tratamento
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