Sternocleidomastoid myocutaneous flap or free flap: Long-term follow-up of soft tissue defect repair in oral cancer

Abstract Objective To evaluate the reliability and long-term efficacy of the sternocleidomastoid (SCM) flap in reconstructing and repairing soft tissue defects after oral cancer surgeries. Study Design A total of 102 patients were assessed, who underwent soft tissue defect reconstruction with the SCM flap after oral cancer surgery from 2012 to 2019. Relevant clinical indicators were analyzed. They were also grouped according to pathological cervical lymph node staging. Postoperative recurrence and metastases were compared with radial forearm free flap (RFFF). Results The flap healing rate was 100% in SCM flap, compared with a success rate of 94% in RFFF. SCM flaps would not increase the risk of dysfunction or paresthesia in the neck dissection area. Prognostically, the rate of cervical lymph node metastasis was similar in patients with pathological cervical lymph node staging N0 and N1 by using both flap types, while the rate of cervical lymph node metastasis was significantly higher in patients with SCM flaps compared to RFFF in N2 patients. Conclusion The SCM flap is a reliable, cost-effective flap with minimal side effects, which is ideal for soft tissue reconstruction of oral cancers if the subjects are selected judiciously. N2 cases are not an indication for SCM flaps.