"Upper traps, levator scapulae and
sternocleidomastoid swoop in and try to give support to the weak muscles.
The patient, having been diagnosed of ACC in her left parotid gland for 3 years, received surgical treatments including a total resection of left parotid gland, transplantation of facial nerve, and transferring of left
sternocleidomastoid muscle flap.
It includes subhyoid depression, which visually enhances the impression that the neck is thin and long; visible thyroid cartilage bulge; a visible anterior border of the
sternocleidomastoid muscle, distinct in its entire course from the mastoid to the sternum; and a cervicomental angle between 105 and 120 degrees.
Therefore, this research had as its intention, to verify if the existence of one chewing side preference, relates with the postural muscular electrical potential, represented by the
sternocleidomastoid muscle, by the upper fibers of the trapezium, gluteus medius and anterior tibialis muscles, bilaterally.
A tracheostomy below the thyroid isthmus and bilateral neck dissection, preserving the spinal accessory nerve, internal jugular vein and
sternocleidomastoid muscle, were performed (Figures 3 and 4).
Then it loops over the hypoglossal nerve and finally descends and opens on the skin of the lower neck along the anterior border of the
sternocleidomastoid muscle.
Falla has reported that both the
sternocleidomastoid and anterior scalene muscles' strength were significantly reduced in patients with neck pain at 25% of maximum voluntary contraction (p<0.05).
Cervical skin crease incision was given on the right side, intra-operatively the cystic mass was seen deep to the
sternocleidomastoid muscle extending superiorly in the para-pharyngeal space and displacing the great vessels, although the mass was not adherent to the surrounding structures but its removal was difficult as it was deep to the carotid, vagus and internal jugular vein (Figure-3).
It then descends diagonally, superficial to the
sternocleidomastoid muscle to reach the subclavian vein (Standring et al.).
The suppression of click evoked vestibulocollic reflex obtained from the
sternocleidomastoid muscle is considered as a consequence of the long duration of dystonia, not a primary co-existing abnormality (5, 12).
A critical assessment of efficacy of
sternocleidomastoid muscle flap which forms an effective tool in avoiding the major unfavourable outcome of surgery is undertaken in this descriptive study carried out on 22 patients.
After cleaning the skin with an antiseptic solution, a hypodermic needle is inserted along the posterior border of the
sternocleidomastoid muscle, landmark was identified as the midline between the mastoid process and clavicular head of the
sternocleidomastoid muscle, and three injections of 5mL of local anesthetic were done behind the posterior border of the
sternocleidomastoid muscle subcutaneously, perpendicularly, cephalad, and caudad in a fan fashion.