The Skin-Sternocleidomastoid Muscle Composite Flap for Neck Dissection (The Gator Neck Flap)

摘要

Radical neck dissection, first standardized by Crile in 19061 involves extensive elevation of the neck skin and sacrifice of the spinal accessory nerve (SAN), and sterno-cleidomastoid muscle (SCM). Frequent postoperative se-quellae included sensory denervation of the neck skin, shoulder dysfunction, and cosmetic deformity. Lack of carotid coverage by the SCM on occasion resulted in carotid blow out, especially in the early days of radiation therapy and use of the trifurcate incision.To address these shortcomings, a modified neck dissection, which preserved the SCM and SAN was described by Suarez in 1963,2 and later improved and popularized by Boca.3 These modifications alleviated many of the disadvantages of the radical procedure while maintaining comparable cure rates. Since that time numerous authors described other modifications in which a segment of the neck most likely to be involved with metastasis is dissected. Again comparable cure rates have been maintained.