Repair of tracheoesophageal fistula with pedicled sternocleidomastoid muscle flap after minimally invasive esophagectomy: A case report

Background: Tracheoesophageal Fistula (TEF) is a rare complication after Minimally Invasive Esophagectomy (MIE). Various surgical methods are available for repairing TEF. In this report, we have shown the importance and feasibility of pedicled Sternocleidomastoid Muscle (SCMM) flap in dealing with TEF. Methods and results: A 57-year-old woman with esophageal squamous cell carcinoma underwent MIE in our hospital. TEF was diagnosed based on some clinical manifestations, like coughing after swallowing, a month after MIE. During the repair operation, we have utilized pedicled SCMM flap to cover the fistula after suturing the esophagus and trachea separately. No major complications occurred after the operation, and the prognosis was good. Conclusions: Pedicled sternocleidomastoid muscle flap was convenient, reliable and efficient in covering the fistula, therefore, we recommend it as the routine surgical method. However, randomized controlled trials are further needed to confirm this recommendation. TEF can be reconstructed with a pedicled SCMM flap. This method can effectively avoid further complications. Keywords: minimally invasive esophagectomy; esophageal cancer; tracheoesophageal fistula; sternocleidomastoid muscle.

Use of a sternocleidomastoid muscle flap to protect the carotid artery during laryngectomy

Objectives This paper describes a simple method of securing tissue coverage of the great vessels at the initial surgery by rotating the divided sternal heads of the sternocleidomastoid muscle, a routine step during laryngectomy, and approximating them to the prevertebral fascia. The paper presents an illustrated case example where this technique in a salvage laryngectomy repair resulted in a protected vascular axis following a salivary leak. Results Since utilising this technique, there has been a marked reduction in the requirement of subsequent flap procedures to protect vessels, and no episodes of threatened or actual carotid blowout.

Method to prevent cheek depression using an island sternocleidomastoid muscle flap with the middle pedicle as a feeding vessel in immediate reconstruction of the facial nerve with the sural nerve following resection of a parotid gland tumor

Many surgeons have demonstrated the validity of sternocleidomastoid muscle flaps for the reconstruction of head and neck tumors. We present a case in which we used an island sternocleidomastoid muscle flap to reconstruct a cheek depression after excision of a malignant parotid tumor. A 44-year-old woman presented with a right malignant parotid tumor. We performed total resection of the parotid gland and facial nerve with the sural nerve and reconstructed the facial nerve and cheek depression with an island sternocleidomastoid muscle flap. The sternal head of the right sternocleidomastoid muscle was cut at the cranial and caudal segments to elevate it as an island flap. We used the superior thyroid artery as the sole pedicle for the island muscle flap. At 1 year and 3 months after the operation, the mimic muscles had gradually recovered and progressed without complications such as Frey syndrome, cervical motor dysfunction, or concave deformation of the neck and cheeks.