All the equipment for this study was provided by the Laboratory of Anatomy, Paris Descartes University.
Facial Plastics and Reconstructive Surgery
Article first published online: 24 SEP 2012
Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.
Volume 122, Issue 11, pages 2402–2406, November 2012
How to Cite
Leclère, F. M., Vacher, C. and Benchaa, T. (2012), Blood supply to the human sternocleidomastoid muscle and its clinical implications for mandible reconstruction. The Laryngoscope, 122: 2402–2406. doi: 10.1002/lary.23430
The authors have no other funding, financial relationships, or conflicts of interest to disclose.
- Issue published online: 25 OCT 2012
- Article first published online: 24 SEP 2012
- Manuscript Accepted: 23 APR 2012
- Manuscript Revised: 21 MAR 2012
- Manuscript Received: 29 JAN 2012
- Sternocleidomastoid flap;
- combined flap;
- mandible reconstruction;
- anatomical study;
- injection technique;
- Level of Evidence: 4
The use of the sternocleidomastoid (SCM) flap for reconstructive surgery of the mandible seems to be a practicable although underestimated option.
This study was conducted on 15 cadavers that had been neoprene–latex injected in the middle and inferior pedicles.
Lengths of the SCM were equally divided into upper, middle, and lower thirds. Each third was then subdivided into numbered quadrants. This procedure defined six levels in the SCM, each corresponding to two quadrants: one medial and the other lateral. For each third of the SCM, the origin of the main pedicles was recorded. The quadrants where neoprene–latex was detected were reported in the dissection book.
The upper third of the SCM muscle was constantly supplied by branches of the occipital artery. The middle third of the SCM muscle received its blood supply from a branch of the superior thyroid artery (right SCM/left SCM: 53%/53%), the external carotid artery (27%/20%), or branches of both (20%/27%). The lower third of the muscle was supplied by a branch arising from the suprascapular artery (73%/73%), the transverse cervical artery (7%/13%), the thyrocervical trunk (13%/13%), or the superficial cervical artery (7%/0%). The neoprene–latex injected into the subclavian artery reached the four lower levels in all SCMs studied (the middle third of the SCM). In 13% of the SCMs, this injection also reached level II (the upper third of the SCM). With a double injection (inferior and middle pedicles), levels I and II were reached in 100% of the cases.
This study shows that, used alone, the lower pedicle does not have the ability to ensure the full vascularization of the SCM muscle. A composite flap might be safely raised only if the integrity of both inferior and middle pedicles is respected.