STRAP MUSCLE NEUROVASCULAR SUPPLY

Objectives/Hypothesis: Knowledge and preservation of the neurovascular supply to strap muscles, such as the sternohyoid (SH) muscle, used in laryngotracheal reconstruction are important in preventing loss of ti ssue and bulk from ischemia and/or denervation, Study Design: Arteriov enous and neural supply variations to the strap muscles were examined in cadaver specimens. Methods: Strap muscle neurovascular supply was s tudied in 16 cadavers, including one transparent corrosion cast specim en with injected vessels. Results: For the upper SH and upper belly of the omohyoid (OMO), the arterial supply consistently arose from a bra nch of the superior thyroid artery (STA) most commonly terminating at the cricothyroid membrane. The inferior SH was supplied by the inferio r thyroid artery. The ansa cervicalis innervated the SH inferiorly wit h a branch below the loop. Each arterial branch to the muscles had an accompanying venous tributary, The corrosion cast specimen demonstrate d that the arterial lumen diameters mere almost threefold larger in br anches entering the upper SH, compared with the lower SH or OMO. Small intramuscular arteries without axial supply were found within the mid dle third of the upper SH, the lower SH, and the upper OMO. Conclusion s: It is possible to preserve neurovascular integrity in an inferiorly based SH flap. The superior and medial borders are released, with dis section of vascular supply laterally and deep to the muscle, and prese rvation of the inferior terminal ansa branch.