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World Journal of Surgery

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01-04-2016 | Innovative Surgical Techniques Around the World

The Sternocleidomastoid Muscle Flap: A Versatile Local Method for Repair of External Penetrating Injuries of Hypopharyngeal–Cervical Esophageal Funnel

Author: Mohamed A. Ellabban

Published in: World Journal of Surgery | Issue 4/2016

Abstract

Introduction

A primary repair of external penetrating injury to hypopharyngeal–cervical esophageal (HP–CE) funnel without reinforcement has more complications if compared with muscle reinforcement. The aim of the present study was to assess the outcome of using sternocleidomastoid (SCM) muscle flap for reinforcement of primary repair of HP–CE funnel injury. The study proposed an algorithm for different uses of SCM flap repair according to site and size of funnel perforation.

Patients and methods

A prospective analysis of 12 patients, who had surgical treatment for external penetrating injuries of HP–CE funnel between January 2011 and September 2014, was recorded. The following factors were studied for each case: demographic data, Revised Trauma Score (RTS), mechanism of injury, time interval between injury and definitive surgical care, injury morphology, any associated injuries, technique of SCM flap used, length of hospital stay, and surgical outcome and complications.

Results

They were 10 males and 2 females and the mean age was 31.9 years. The cause of injury was stab wound in 5 (41.7 %) cases, gunshot injury in 4 (33.3 %) cases and 3 (25 %) cases after anterior cervical spine surgery. Isolated injury to HP and CE was recorded in 5 cases (41.7 %) for each site. However, 2 (16.7 %) cases had injury to both HP and CE. Cranially based SCM flap was mainly used in cases with HP injury and caudally based flap in CE cases with some limitations. The whole muscle flap was used in large (≥1 cm) defects while and the split muscle flap in small (<1 cm) defects. Oral intake started 7 days postoperatively with only one (8.3 %) case of small leakage, which was treated conservatively.

Conclusion

The SCM flap is a very useful and versatile tool in reinforcement of HP–CE funnel injury with the advantages of high success rates of leakage prevention.

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Title: The Sternocleidomastoid Muscle Flap: A Versatile Local Method for Repair of External Penetrating Injuries of Hypopharyngeal–Cervical Esophageal Funnel
Author: Mohamed A. Ellabban
Publication date: 01-04-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 4/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-015-3306-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The Sternocleidomastoid Muscle Flap: A Versatile Local Method for Repair of External Penetrating Injuries of Hypopharyngeal–Cervical Esophageal Funnel

Abstract

Introduction

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusion

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