Sternocleidomastoid-Clavicle Myoosseus Flap in Patient with Plate Displacement Post Resection and Reconstruction of Ameloblastoma

Abstract

Background: ameloblastoma is a common tumor found in head and neck disorder. The definitive treatment include resection of tumor and reconstruction for filling the large defect which left after tumor resection. The reconstruction option which can be done is flap method. In this case, we used sternocleidomastoid-clavicle myoosseus flap in our patient with post traumatic plate displacement post resection and reconstruction of ameloblastoma. Case: a 22-year-old woman presented with unstability of jaw after hitting her chin to the table since 3 days prior to admission. On 2011, she had history of ameloblastoma which got resected and reconstructed with fibular graft and plate in the same year. While the plate seemed to be broken, she was managed with plate removal and reconstruct with sternocleidomastoid-clavicle myoosseus flap. Post operation, patient managed with gradual diet from liquid to solid. Observation Post Operation Day (POD) 3, flap is vital. Patient is discharged on POD 7 and visit as outpatient every 3-5 days until POD 14. Finally, we remove the suture, operation scar is good, and the flap is vital during one year follow up. Conclusion: sternocleidomastoid-clavicle myoosseus flap is practical and safe procedure, which can be used as alternative option in mandible reconstruction.

Reconstruction of Oromandibular Defect After Tumor Resection by Sternomastoid-clavicular Flap

“…This flap is a rapid, practical, safe, technically easy flap to elevate for 1-stage immediate reconstruction of oromandibular defects. 31 It can be applied even in patients received preoperative radiotherapy without risk of infection or bony or cutaneous flap necrosis. 32 The main drawback of SCM-OMCF is limited arc of rotation which is determined by the course of the spinal accessory nerve and the risk of transecting the occipital artery if neck dissection of cervical lymph nodes (level II and IV) is done.…”

“…SCM-OMF has been used previously as SCM-OMCF compose of harvesting a part of the clavicle carrying a muscle, skin paddle, periosteum, and bone graft directly. This flap is a rapid, practical, safe, technically easy flap to elevate for 1-stage immediate reconstruction of oromandibular defects 31 . It can be applied even in patients received preoperative radiotherapy without risk of infection or bony or cutaneous flap necrosis 32 …”