Sternocleidomastoid Muscle Flap in an Older Patient With Congenital Muscular Torticollis.

Congenital muscular torticollis (CMT) is caused by muscle damage during childbirth, tumors, or masses within the muscles and generally resolves with physical therapy during infancy. In this study, we performed reconstruction after resection of a parotid gland tumor using a sternocleidomastoid muscle (SCMM) flap in an older patient with neglected CMT. The patient was a 64-year-old woman who had had a left-sided oblique neck since infancy but had never received any treatment, including physical therapy. She underwent parotid tumor resection and SCMM flap transfer. The SCMM flap can be safely elevated using indocyanine green fluorescence angiography, with the middle pedicle serving as the feeding vessel to fill the parotid defect. Three months after surgery, the torticollis had improved and the cheek depression was not noticeable, indicating the effectiveness of surgical treatment for CMT in older patients and the possibility of using SCMM as a muscle flap.

Analysis of reconstructed oropharynx shape after total glossolaryngectomy reconstruction using a free rectus abdominis musculocutaneous flap.

Introduction: Restoring oral intake through oropharyngeal reconstruction is vital for patients undergoing total glossolaryngectomy. Despite its importance, research in this area is limited, leaving clinicians with few guidelines. The debate regarding the optimal shape of the reconstructed oropharynx highlights the need for further research. Methods: This retrospective study analysed data from 16 consecutive patients who underwent primary reconstruction with a free rectus abdominis musculocutaneous flap after total glossolaryngectomy at the University of the Ryukyus Hospital between April 2015 and March 2022. Parameters assessed included reconstructed oropharynx shape (flat or funnel-shaped), demographics, flap characteristics, post-operative course and oral intake outcomes. Results: Among the 16 patients, 10 had flat oropharynx, whereas 6 had a funnel-shaped oropharynx. At 6 months post-surgery, 13 patients resumed oral feeding, whereas 3 did not. Significant differences were observed between the groups in preoperative body mass index (21.1 kg/m² vs 17.8 kg/m², Welch's t-test, p=0.035) and days until the first oral intake (34.2 days vs 19.2 days, Welch's t-test, p=0.01). However, no significant differences were found in the form of oral intake at 6 months after surgery (Fisher's exact test, p=0.518). Conclusion: This study suggests that the shape of the reconstructed oropharynx (flat or funnel-shaped) does not significantly impact long-term post-operative oral intake. These findings provide valuable insights into oropharyngeal reconstruction outcomes after total glossolaryngectomy and offer guidance for future research in this area. Nevertheless, further studies are warranted to elucidate the clinical implications of these findings and address any limitations of this study, particularly those regarding sample size constraints.