THE STERNOMASTOID ISLAND MYOCUTANEOUS FLAP FOR ORAL-CANCER RECONSTRUCTION

Objective: To evaluate the usefulness of the sternomastoid island myoc utaneous flap for reconstruction of defects after excision of oral can cer. Patients: One hundred eleven superiorly based sternomastoid islan d myocutaneous flaps were used for one-stage primary reconstruction in 110 consecutive patients with oral cancer during a 53-month period fr om June 1985 to November 1989. Results: Ninety-eight patients had radi ation therapy before surgery. One hundred six flaps were used for muco sal lining of the mouth and six flaps were used for providing skin cov er. Flap-related complication developed in 38 patients (34.5%). Total flap loss occurred in eight patients (7.3%). Radical irradiation befor e surgery significantly increased flap-related complications. Low-mole cular-weight dextran did not improve flap survival. After a minimum fo llow-up of 24 months, nine patients (8.2%) had recurrences in the ipsi lateral neck. The flap could easily reach the oral cavity without prod ucing tensio on the suture line. The flap also did not produce excessi ve bulk in the mouth or on the face. Conclusion: In a selected group o f patients with a clinically NO neck, the sternomastoid island myocuta neous flap is oncologically safe and it gives satisfactory cosmetic an d functional results with no lasting morbidity.