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Sternocleidomastoid muscle flap for reconstruction of mastoidectomy defects
Kia M. Washington
Frederick R. Heckler
University of Pittsburgh Medical Center
2010-04-04
Presenter: Kia M. Washington
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Craniomaxillofacial
Introduction: Obliteration of the mastoid cavities from extirpative surgery, osteoradionecrosis, and revision surgery for chronic otitis media often result in large postoperative deformities. Various techniques to alleviate the size of the surgical defect have been developed. However standard reconstruction options are often not reliable, or can have unfavorable outcomes. We have utilized a sternocleidomastoid muscle flap for the reconstruction of the mastoid defects. Methods: An incision is made through the skin and subcutaneous tissue to expose the sternocleidomastoid muscle in the postauricular sulcus. The sternocleidomastoid is elevated off the insertion on the mastoid process down to the entrance of the dominant pedicle, a branch of the occipital artery. The muscle is advanced in to the defect. Skin is closed over the muscle Results: The sternocleidomastoid muscle flap was used in 3 patients who presented with mastoid defects from a variety of disease processes. All 3 of the flaps survived in the patients without donor site complications, flap necrosis, or recurrence of disease. Conclusion: The sternocleidomastoid muscle flap is a viable option for reconstruction of mastoid defects after surgical procedures for chronic ear disease and skull base operations.
