Sternocleidomastoid muscle flap: an option to seal off the esophageal leakage after free jejunal flap transfer--a case report.

Necessary requirements for the successful management of an esophageal fistula are the following: functional closure of the defect, control of infection, shortened period of hospitalization, and minimal donor-site morbidity. A sternocleidomastoid (SCM) muscle flap meets those requirements. Furthermore, the SCM muscle flap is already a well established treatment for non-oncologic patients, although the procedure has received criticism for head and neck reconstruction in patients with malignant disease of the upper aerodigestive tract. In this report we describe the utility of a SCM muscle flap, as a buttress for repairing a frank clinical leak after esophageal reconstruction with a free jejunal flap, in a selected patient with a clinically N0 neck. No clinical leakage was found postoperatively. After a two-year of follow-up, the patient could eat solids without the need for additional nutritional supplementation. No tumor recurrence was noted.