Background. The use of the sternocleidomastoid (SCM) muscle in the repair of soft tissue defects arising after surgery for neoplasms of the head and neck has been a subject of controversy. We describe a variant of the SCM muscle flap called the “SCM myofascial flap” and report our experience with this flap in head and neck reconstruction.

Methods. Six patients underwent head and neck reconstruction with the SCM myofascial flap. The head and neck defects included partial laryngeal, pharyngeal defects, and concave soft tissue neck defects after resection.

Results. Follow-up of the patients ranged from 6 to 91 months. In the case of laryngeal and pharyngeal reconstruction, all had a good voice and were able to eat by mouth without aspiration. Two of the four patients were decannulated. The only complication was a laryngocutaneous fistula.

Conclusion. We have used this flap with success, in soft tissue augmentation and in laryngeal and pharyngeal reconstruction following tumor resection. The technique and the results of our experience are discussed. We believe that in selected cases, the SCM myofascial flap is ideal for reconstruction of head and neck defects. © 1994 John Wiley & Sons, Inc.